Senior Professional Coding and Documentation Improvement Specialist - FT - Day - Physician Professional Coders Lawrenceville NJ

Capital Health (US) • Pike, NY

4d • Onsite

About The Position

Capital Health is seeking a Senior Professional Coding and Documentation Improvement Specialist to lead complex coding reviews, optimize provider documentation, and improve coding accuracy and compliance. This role provides assistance and support to the manager regarding time management, workflow delegation, and knowledge of industry guidelines, laws, and regulations. The specialist will assist in analyzing and reporting record review findings to monitor trends and outcomes. Key responsibilities include coordinating physician education sessions, managing correspondence with physicians, maintaining the Capital Health Medical Group (CHMG) educational website, and coordinating and delivering large group education sessions for all CHMG providers.

Requirements

• High School Diploma or equivalent.
• Certified Professional Coder (CPC) or Certified Coding Specialist-Physician-based (CCS-P) required.
• Physician coding and Training certification.
• Three years’ experience in professional coding role with monitoring and education experience required.
• ICD-10-CM, CPT, CM, and HCPCS coding experience.
• Excellent verbal and written communication skills.
• Knowledge of pathophysiology and disease processes.
• Strong knowledge of industry guidelines and laws for physician coding and reimbursement.
• Possesses research and analysis skills.
• Proficient with Microsoft applications to include Outlook, Word, Excel, PowerPoint.
• Medical Terminology, Anatomy and Physiology, or Pathophysiology knowledge.
• Ability to develop, implement and deliver, and assess coding education plans using a variety of methods to individual providers or provider groups.
• Ability to work in environment using multiple EMR systems.
• Ability to learn and develop auditing and education skills to perform physician education.
• Ability to work collaboratively with others as well as independently.

Nice To Haves

• Associate's degree in health information management preferred.

Responsibilities

• Assists manager with ongoing monitoring and education process by assuming responsibility for coordination and scheduling, as well as research, design and delivery of large group education sessions to ensure accurate and compliant physician documentation and coding.
• Researches and provides up-to-date information to departmental staff to promote compliance with industry and government regulations.
• Research coding and reimbursement issues and reports findings to manager, physicians, and staff.
• Develops and coordinates education and training programs on coding and documentation for department staff, physicians, and ancillary departments.
• Performs analysis and trending of record review results to achieve optimal coding accuracy and compliance of CHMG providers.
• Develops and disseminates customized education programs to educate CHMG providers regarding documentation requirements needed for accurate code assignments.
• Monitors provider selected E&M codes on a routine and focused basis to ensure documentation supports medical necessity, code specificity, and compliance to promote the highest coding accuracy.
• Support external audit responses and mitigation efforts.
• Meets or exceeds departmental accuracy and productivity standards.
• Fosters teamwork and collaboration.
• Proactively troubleshoots documentation or communication problems and appropriately escalates to senior level.
• Maintains a level of expertise by attending continuing education programs.
• Adapts to changing department demands required for higher department efficiency.
• Assists manager in the training of new employees in an effort to maintain a productive workforce and environment.
• Performs all other duties as assigned.

Benefits

• Medical Plan
• Prescription drug coverage & In-House Employee Pharmacy
• Dental Plan
• Vision Plan
• Flexible Spending Account (FSA) - Healthcare
• FSA - Dependent Care
• Retirement Savings and Investment Plan
• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance
• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance
• Disability Benefits – Long Term Disability (LTD)
• Disability Benefits – Short Term Disability (STD)
• Employee Assistance Program
• Commuter Transit
• Commuter Parking
• Supplemental Life Insurance - Voluntary Life
• Spouse - Voluntary Life
• Employee - Voluntary Life
• Child Voluntary Legal Services
• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance
• Voluntary Identity Theft Insurance
• Voluntary Pet Insurance
• Paid Time-Off Program

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: High school or GED