At the direction of the Manager, assume responsibility for coding audit activities for provider groups assigned to the team.
- Coordinates and conducts audits for documentation of coding in assigned clinical sections.
- Coordinates coding feedback of documentation review results in on-going written communication for providers.
- Monitors provider documentation and coding in all professional and hospital outpatient settings.
- Responds to questions regarding coding and documentation practices. Conducts process evaluation and researches topics and develops education plan.
- Researches issues related to coding and documentation practices. Develops communication and distribution strategies.
- Evaluates and recommends possible changes to coding or documentation practices.
- Assimilates information; identifies key issues, and presents pertinent information to the team.
- Identifies coding trends through data analysis and assists in the evaluation of coding data with team.
- Coordinates response to compliance concerns through management.
- Participates in the development of new coding policy.
- Maintains membership in professional organizations, attends conferences and workshops and relationships with payors. Ensures that current information is secured, maintained and distributed to providers.
- Applies mandated coding guidelines to documentation, including E/M code assignment, auditing and education.
- Performs other duties as required or assigned.
- High school graduate with 4 years of coding experience required.
- Previous experience in abstracting for coding in professional and hospital outpatient areas like E&M, ED and OR preferred.
- Strong organizational and analytical skills with the ability to effectively communicate, both orally and in writing with all levels of staff.
Required Licensure/Certification Skills:
Certified Professional Coder (CPC), Certified Professional Coder-Hospital (CPC-H), or Certified Coder Specialist-Physician Based (CCS-P) certification required