|Employer:||East Alabama Medical Center
|Required Certifications:||AAPC or AHIMA
|Required Experience:||1 to 2 years
|Preferred Experience:||3 to 4 years
REMOTE QUALITY ASSURANCE EDUCATOR
General Purpose: The educator will be required to gather data for interpretation and identify unfavorable trends and will facilitate recommendations to improve procedures, strengthen controls, enhance revenue and improve cash flow. The educator will conduct training as needed to help ensure improved accuracy of coding documentation.
• Applies knowledge of CPT and ICD-10 coding guidelines, billing documentation and documentation standards.
• Applies knowledge of federal, state and commercial payer billing and payment policies.
• Act as a professional coding expert for the organization.
• Assists with the appeals for denials for services performed as needed.
• Minimize claims cycle-times, defects and rework.
• Ensure accurate and complete coding daily.
• Provides exceptional customer service to East Alabama Medical Center providers, clinic operations team, patients and other internal customers.
• Execute daily workload within full compliance of state and federal billing regulations.
• Seeks opportunities to improve coding processes including increased productivity and accuracy.
• Document education in a clear, concise and consistent manner to enable quality assurance reviews which will help ensure accuracy of the findings and that no other issues exist.
• Hold education trainings for billing staff, providers and other clinical staff.
• Meet with providers, clinical and coding staff as identified in the audit compliance plan to educate on identified risk factors from the audit findings.
• Assist the Patient Accounts team with processing charges when needed.
Job Qualifications knowledge, skills and abilities:
• Ability to interact positively and build rapport with patients, coworkers and/or external contacts.
• Ability to work independently and organize work in a manner that ensures accuracy and efficiency.
• Ability to analyze and synthesize data to determine the appropriate program.
• Ability to troubleshoot, analyze and problem solve.
• Ability to exercise effective judgment, sensitivity, creativity to changing needs and situations.
• Ability to manage multiple projects to successful completion at a given time.
• Ability to demonstrate the capability to effectively and sensitively respond to the needs and concerns of the full range of East Alabama Medical Center’s diverse patient population.
• Ability to handle sensitive information ethically and responsibly.
• Ability to protect the confidentiality of patient, employee and business information.
• Ability to develop educational materials and conduct live one-on-one and/or group training for coding staff and Medical Providers.
• Ability to communicate to all staff in a professional manner.
• Provide exceptional customer service to East Alabama Medical Center’s providers, clinic operations team, patients and other internal customers.
• Advanced knowledge of medical terminology, abbreviations, techniques; anatomy and physiology; major disease processes; pharmacology; and the metric system to identify clinical findings, to support existing diagnoses, or substantiate listing additional diagnoses in the medical record.
Education or Formal Training:
• High school diploma or GED required
• Certification through AAPC or AHIMA credential required
• 3-5 years of coding experience using ICD-9-CM10, CPT, and HCPCS codes preferred
• Experience with Cerner and Optum CAC a plus
• Experience charge coding, E/M leveling, and infusion and injection coding
• Familiarity of interdepartmental interactions as it relates to revenue cycle.
• Medical, Dental, and Optional Vision Insurance
• Earned-Time-Off (ETO)
• Company Paid Life Insurance
• A 403B retirement savings plan & match
• Flexible Spending Account (FSA) and Dependent Care options