The Coding Education Specialist takes part in the development, implementation, and evaluation of all MGPO Coding Education offerings using a variety of mediums. Reporting to the Coding Education Manager, the Coding Education Specialist is responsible for all PBO Coding Department training and education needs, as well as quality assurance assessments, curriculum development and planning, educational materials related to Coding job requirements. The Coding Education Specialist is also responsible for assisting non certified coders with certification exam preparation as requested by Coding Education Manager.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Education and Training
In collaboration with Senior Coding Management, assess departmental Coding training needs. Identify areas for potential coding training initiatives and work with Coding Management Team to provide education and training to coding and non-coding staff as appropriate.
Is responsible for curriculum design and development for the purpose of training coding and non-coding staff, improving job performance and broadening skill set as appropriate.
Formulate recommendations for coding education and deliver in-service presentations to the Coding Department and/or MGH and MGPO practices including physicians and non-physician practitioners, coders, and practice staff as appropriate.
Design and deliver department-specific eLearning and classroom training modules
Monitor and report on individual and group training events.
Work with relevant departments to develop and maintain Coding and Compliance guidelines
Partner with Coding Management to deliver comprehensive training on MGH/MGPO Coding guidelines
Responds to coding and billing questions as well as coding related projects as needed
Review, conduct and document competency assessments. Identify areas for improvement and work with Coding Management Team to provide education and training on these areas. Report findings on a regular basis to Coding Management.
Perform baseline and ongoing quality assessments of MGPO coder work quality including but not limited to proper coding convention and guidelines, MGPO/PBO policies, and governmental and/or payer guidelines as appropriate. Identify areas for improvement and work with Coding Management Team to provide education and training on these areas. Regularly reports findings to Coding Management
Identify and document coding trends through frequent interaction with Coding Specialists and coding reviews. Identify areas for improvement and work with Coding Management Team to provide education and training on these areas. Reports all findings to Coding Management
Analyze key quality statistics and benchmarks for reporting and regularly prepare reports as indicated by Coding Education Manager for Senior Management
All other duties as assigned
- Proficient in ICD-9, ICD-10, CPT®, HCPCS, and Modifiers for coding professional services.
- Knowledge of hospital coding preferred but not required.
- Working knowledge of anatomy and physiology, medical terminology and insurance reimbursement policies and regulations.
Excellent analytical and problem solving skills
Excellent written and verbal communication skills
Ability to interact with people from all organizational levels and build consensus through negotiation and diplomacy
Ability to understand the work environment and competing priorities in conjunction with developing/meeting project goals
Ability to plan and prioritize tasks accordingly
Proficiency with software such as Microsoft Office (Word, Excel, PowerPoint)
LICENSES, CERTIFICATIONS, and/or REGISTRATIONS:
§ Coding Certification from American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) is required. Certification may include CPC®, CPC-H, CCS, CCS-P.
§ Advanced Specialty or additional related certifications preferred but not required.
Bachelors degree preferred but not required
High school Diploma required
§ Completion of a Certified Coding Specialist certificate program or Health Information Technology Program or work experience required.
§ Coding certification and three - five years progressively responsible experience in a healthcare setting using knowledge of third party payers and insurance requirements, experience coding for professional fee services required
The MGPO Professional Billing Office is located in the Charlestown Navy Yard campus
The hours are usually Monday through Friday 8:00 AM to 4:30 PM but vary according to the business needs.
The work environment is very busy and dynamic
Staff is very collaborative and work together to solve issues with particular practice issues
There are often multiple conversations occurring at the same time – the staff needs to be able to handle an environment that is not quiet
The employee is required to travel to any Partners’ facilities to attend off-site meetings. This includes travel to new client sites