Education Consultant Jobs

About The Position

Requirements

• Current, active, unrestricted Inpatient Coder Certification (CIC, CCS, RHIT, RHIA etc.)
• 5+ years of experience as a Certified Inpatient Coder in a healthcare setting including knowledge of industry terminology, and regulatory guidelines
• 3+ years providing formal training on medical coding and/or customer service experience
• Fully proficient with MS products such as Word, PowerPoint, and Excel (Pivot Tables, etc.)

Nice To Haves

• A current, active, unrestricted nursing license (RN, LPN, etc.)
• Training Certification
• CDI Certification
• Managed care experience
• Investigational and/or auditing experience
• Knowledge of claims platforms

Responsibilities

• Create and deliver presentation materials to facilitate provider education
• Lead provider education meetings to drive issue resolution, including potential onsite provider meetings
• Apply principles of adult learning and training best practices to deliver effective and innovative training material
• Create supporting materials for learning activities (e.g., agendas, schedules, letters, audio/visual aids, etc.)
• Leverage/modify existing training solutions to meet current needs
• Act as a subject matter expert for internal and external partners in the form of assistance with medical coding, documentation requirements based off industry standards
• Ensures adherence to state and federal mandates for all coding guidance, applicable benefit language, medical & reimbursement policies, coding requirements and consideration of relevant clinical information
• Possesses strong decision-making skills on complex claim audits
• Analyze and interpret claims data and medical records/documentation to understand the historical activity and determine validity of the payment/denial on a claim
• Identifies aberrant billing patterns and trends, evidence of fraud, waste, or abuse, and recommends providers to be flagged for review
• Maintains and manages daily assignments, with accountability to quality, utilization, and productivity standards
• Discussing the findings as a collaborative team with UHN advocacy, UHC PPS and analyst before approaching the provider call
• Maintaining positive provider and network relationships
• Actively owning and resolving issues for Best in Class and / or high-profile providers encountered during education session
• Analyze data trends prior to education outreach to ensure provider billing errors are addressed in a holistic fashion
• Managing individual workload with a high emphasis on quality
• Demonstrated written, verbal, analytical, organizational, time management and problem-solving skills with proven ability to work independently
• Assume additional responsibilities as assigned

Benefits

• comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution