Perform, monitor the billing clearance per TPR policy for newly onboarded clinicians, APRNs, physician assistants, coders and ancillary staff performing coding functions. Provide continual coding education to clinicians and ancillary staff in compliance with TPR coding policies along with payer and governmental entities regulations and policies. Identify and mitigate risks to the organization by ensuring billed services are accurately coded. Research updated coding information, rules, laws and statutes for all payers and government entities and proactively educate providers and staff. Monitor coding patterns, perform audits and provide feedback to the clinician and/or staff. Review and respond to coding questions from clinicians and ancillary staff. Perform analysis of benchmark to actual on coding related Key Performance indicators. Monitor and track coding holds, denials. Develop a strategic plan for prevention of coding holds and denials complete with benchmarks and milestones. Coding Vendor Liaison, lead interaction between the vendor and the assigned market(s). Develop a recovery plan to include remediation as approved by the regional coding director for coding errors. Organize and participate in coding team meetings. Complete Special projects.
Qualifications
Education:
Required: High School Diploma or equivalent
Preferred: Post-secondary Anatomy and Physiology
Experience:
Required:2-3 years coding, training, or auditing experience in a multi-specialty medical environment. Strong knowledge of Medical Terminology Strong communicative skills. Foster positive interaction with clinicians and staff. Knowledge of government regulations for coding and documentation for professional coding
Certifications:
Preferred: AHIMA or AAPC coding credentialed, CPC or CCS minimally
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Description
The Coding Educator (CE) functions under the direction of the Tenet Regional Coding Director. The CE is responsible for ensuring the TPR coding guidelines, payer guidance and policies along with governmental regulations pertaining to coding and documentation are met within the TPR organization. The CE is responsible for presenting continuous coding education to clinicians and support staff. The CE is responsible to prevent coding denials through quality and quantitative analysis, tracking and monitoring post education performance. The CE operates as the coding vendor liaison inclusive to but not limited by monitoring daily coding accuracy and coding turnaround times. The CE continuously investigates MAC releases and updates, CMS guidance and regulations and payer updates to improve coding performance and compliance. The CE is responsible to audit and provide results, discuss opportunity improvements to newly onboard clinicians, advanced practitioners, physician assistants and any staff that performs coding functions in the assigned TPR market. This is extended to established providers the CE has identified as needing additional coding guidance. The CE will perform various audits based on quality tools including the TPR Bell Curve.
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