|Employer:||Bridges Health Partners
|Skills:||Comprehensive knowledge of coding practices and guidelines in physician and hospital setting,including hierarchical condition categories
|Required Certifications:||Certified Professional Coder
|Required Experience:||5 to 7 years
|Preferred Experience:||5 to 7 years
|Location:||Warrendale (Pittsburgh area), PA
Responsible for providing training on quality performance standards, hierarchical condition category, evaluation and management, and other healthcare coding to providers. Performs analysis of existing coding practices of providers and identifies areas of improvement by performing the following duties.
- Conducts training needs assessments across the Bridges Health Partners Clinically Integrated Network (CIN).
- Develops training programs on proper coding for physicians and other providers.
- Leads training programs on coding across the Bridges Health Partners CIN.
- Performs quality assurance reviews of patient charts to assess the effectiveness of the coding training.
- Organizes and leads various coding meetings.
- Serves as point of contact for Bridges Health Partners providers and office staff on coding questions and issues.
- Responsible for staying current on coding changes and modifies training programs as appropriate.
- Conducts continuous coding reviews and identifies areas of potential improvement at the network and practice level.
- Performs benchmarking studies on Bridges Health Partners providers; develops and implements network coding campaigns using Bridges Health Partners reporting tools.
- Conducts coding and claims submission audits to ensure documentation accurately supports coding and that codes are being appropriately transmitted to the various payors through complete claims.
- Provides continuous coding and payer updates.
- Reviews coding reports and develops targeted training as appropriate.
- Provides coding education to new providers that join the Bridges ACO and/or CIN.
- Participates in Bridges Health Partners committee meetings as required.
- Comprehensive knowledge of coding practices and guidelines in physician and hospital setting, including hierarchical condition categories
- Solid understanding of Medicare quality programs, Medicare ACO programs, and Clinically Integrated Networks
- Knowledge of various electronic health records
- Proficient in Microsoft Excel, Microsoft Word, and Microsoft PowerPoint
- Strong analytical skills
- Excellent oral and written communication skills and the ability to provide financial presentations to senior management, Boards of Directors, and committees
Basic Qualifications and Experience
- Bachelor’s degree
- Minimum of five (5) years of experience in providing coding education to physician
- Certified professional coder certification required