HCC Coding Education Specialist - Medical ManagementRequisition # 20002468 Apply Now
The Coding Education Specialist (CES) is responsible for reviewing chart notes for accurate code assignment with an emphasis on provider education, documentation and coding improvement, and revenue capture. Provides education to clinicians, clinic staff, and others as needed via face-to-face meetings, classroom settings and webinars. Develops, maintains and presents coding and compliance informative materials to staff and clinicians. In addition, collaborates with the Manager of Physician Coding Education to support the needs of PBS where coding expertise/education is needed. This position is also responsible for analysis and assessment of governmental and non-governmental payer audits, conducts focused reviews and oversees provider compliance with medical record documentation after training and education.
Essential job duties and responsibilities:
- Acts as liaison to clinicians to include review, education and vital follow-up to help ensure that clinical documentation and coding services meet government and organizational policies and procedures.
- Analyzes and provides education on revenue capture, clinical documentation including Electronic Health Record (EHR) requirements, coding accuracy and denial management to clinicians and clinic staff.
- Assists in determining educational needs based on documentation reviews, provider/staff feedback, data analysis (bell curves).
- Reviews coding and documentation for new providers for accuracy and charge capture as per standard.
- Responsible for sending coding reports to providers received from coding vendor resources
- Communicates directly with providers on coding feedback and chart review findings
- Prepares vital reports and communicates results of audits to management, clinicians, and committees as appropriate.
- Reports areas of risk directly to the Manager.
- Maintains a high level of proficiency in assigned specialty and other areas and compliance with government regulations by attending appropriate workshops and seminars.
- Leads all aspects of Medicare and other Payer rules for updates and changes.
- Uses spreadsheets to log physician performance results and to re-educate on those outstanding issues and trends.
- Maintains familiarity with such issues as HCFA E/M Documentation Guidelines, HCFA Teaching Physician Documentation Guidelines and the OIG model compliance plans.
- Attends seminars and workshops, as applicable, for updates on new coding rules and regulations.
- Understands coding trends by billing area, location, and provider for all groups and physicians.
- Handles in a professional and confidential manner all correspondence, documentation, and files.
- Supports Cedars-Sinai Medical Network’s core values, policies, and procedures.
- High school diploma or GED required. Bachelor’s degree preferred.
Certified Procedural Coder (CPC) required.
- Minimum of three (3) years of coding experience in advance professional multi-specialty specific CPT, ICD-10 codes required.
- Minimum of two (2) years of experience in chart audits/reviews/education and training required.
- Understanding of Epic is preferred.
- Demonstrated experience serving in a consulting or advisory role with regard to coding compliance.
- Extensive knowledge of coding surgical procedures and applicable modifiers in multi-specialty setting.
- Understands and applies appropriate PATH guidelines to coding.
- Understands various reimbursement initiatives, including Medicare and Medi-cal
- Knowledge of data flows in a health care organization; experience with physician billing preferred.
- Understanding of computer systems, as well as knowledge of computer programs such as Word and Excel.
- Working Title: HCC Coding Education Specialist - Medical Management
- Department: Medical Management
- Business Entity: Medical Network Foundation
- City: Beverly Hills
- Job Category: Patient Financial Services
- Job Specialty: Medical Coding
- Position Type: Full-time
- Shift Length: 8 hour shift
- Shift Type: Full-time
Cedars-Sinai is an EEO employer. Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law. If you need a reasonable accommodation for any part of the employment process, please contact us by email at Applicant_Accommodation@cshs.org and let us know the nature of your request and your contact information. Requests for accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this email address.
Cedars-Sinai will consider for employment qualified applicants with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring.
At Cedars-Sinai, we are dedicated to the safety, health and wellbeing of our patients and employees. This includes protecting our patients from communicable diseases, such as influenza (flu). For this reason, we require that all new employees receive a flu vaccine based on the seasonal availability of flu vaccine (typically during September through March each year) as a condition of employment, and annually thereafter as a condition of continued employment.
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