System Professional Coding Provider Review and Education Manager

RWJBarnabas Health•Oceanport, NJ

28d

About The Position

The System Professional Coding Provider Review and Education Manager is responsible for onboarding, educating, and reviewing medical record documentation and coding processes of the Medical Group physicians, APNs and other billing providers across all medical centers within the RWJBH enterprise. This includes onboarding education, medical record reviews, targeted education to physician groups and individual physicians, annual and quarterly updates, and ongoing scheduled education sessions as determined in collaboration with coding and physician management. Education will be available in both live on-site and remote presentation formats. The selected candidate for System Professional Provider Review and Education Manager must be prepared to engage in cross-functional duties for the Coding Quality and Review Manager, as aligned with organizational priorities and leadership guidance. These may include conducting medical record audits, supporting coding operations and contributing to administrative functions as needed. Managers must also be prepared to support each other in cross-functional oversight of coding staff as needed and directed.

Requirements

CPC, COC, or CPC-I (aka AAPC approved instructor) required, with at least 8-10 years of combined coding, teaching, and auditing experience.
Associate's Degree or equivalent experience required.
Minimum 3 to 5 years of experience in a managerial position.
Proficiency in Microsoft Office Suite (Excel, PowerPoint, Word)
Must have advanced coding education and training with strong foundation in E/M coding.
Prior experience in teaching and auditing E/M coding for physicians is required.
Must have extensive knowledge of CPT, HCPCS, and ICD-10-CM Official Coding Guidelines, with a comprehensive understanding of diagnosis and procedure coding systems
Must have in-depth knowledge of coding processes, workflow management, and electronic health record (EHR) systems
Must be proactive and work independently to prioritize multiple tasks and changes in work assignment to meet established deadlines.
Must be able to work in a fast-paced healthcare environment, work well under pressure and have the ability to adapt to a constantly changing environment.
Must possess organizational and planning skills, excellent verbal and written communication skills, and excellent interpersonal relationship skills.
Must maintain active certification(s) and participate in continuing education as required by credentialing bodies.

Nice To Haves

CPMA strongly preferred.
Supervisory experience in a healthcare or coding environment strongly preferred.
Coding software platforms (e.g., 3M, EncoderPro, Epic) preferred.

Responsibilities

Manages staff of educators to ensure quality and accuracy of education trainings and provides or initiates appropriate additional education as needed. Tracks staff productivity and ensures equitable distribution of work effort.
Prepares materials and conducts employed provider coding documentation and billing education as needed and determined by the RWJBH Medical Group Coding Steering Committee and Coding Management, in accordance with new provider onboarding (pre- and post-acquisition), and as requested by Compliance and/or Management. Topics may also be determined following medical record review results.
Utilizes appropriate federal, state and/or coding guidelines to format educational materials. Includes redacted medical record example(s) to illustrate compliant and/or non-compliant documentation.
Responsible for creating and delivering annual and/or quarterly CPT, HCPCS and ICD-10 updates to providers, including specialty-specific updates as warranted or requested.
Responsible for creating and maintaining education schedules in collaboration with physician leads.
Ensures accuracy and integrity of ICD-10-CM and CPT procedure coding for professional fee accounts for the purpose of maintaining compliance with Federal and State Coding Regulations.
Keeps current with relevant coding guidelines and Federal and State regulations, including but not limited to Evaluation and Management coding guidelines, Split / Shared services, Incident-to requirements, Teaching Physician Rules, and Telehealth rules and regulations, preparing the associated updated presentations. Delivers said education in person or remotely to RWHBH Provider staff as directed by management
Maintains a shared organizational repository with appropriate guidelines and regulations regarding physician medical record documentation practices, including but not limited to the above topics.
Delivers education and training delivery either remote or in person, as determined by management and deemed appropriate to the individual situation.
Maintains attendance records in a singular database (e.g., Excel)
Works collaboratively with Physician Billing Reviewers to present coding education to providers, along with appropriate coding references, and other materials associated with the findings of completed reviews of employed providers.
Prepares and maintains detailed reports of educational activities.
Maintains and staff internal "Coding Hotline" with knowledgeable staff.
Effectively communicates coding recommendations and reasoning to medical staff members and others.
Corresponds with the AMA and other relevant organizations as necessary
Has effective collaborations with clinicians, health care providers, Revenue Cycle and Coding leadership.
Supervises and supports Provider Education and Coding Staff.
Performs other duties as assigned.