Job Description

Community Health Systems is one of the nation’s leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.

Summary: Trains and educates CHS affiliated providers and/or staff on the appropriate coding and documentation guidelines to stay in compliance with all federal, state, and local rules, regulations and laws. Periodically the Physician Education Specialist will be required to perform education in accordance with the CHS Corporate Physician Compliance Review Plan of CHS affiliated providers that meet the specific criteria for assigned providers.

Essential Duties and Responsibilities include the following:

Conducts educational training workshops and/or webinars to CHS employed providers and/or staffIdentifies and communicates educational needs to providers and staff regarding coding and documentationRemains current on all changes in legislative regulations that impacts coding, documentation, and complianceAssists in developing and maintaining educational materials needed to achieve compliance with regulationsPresents recommendations to CHS management as well as the provider and/or staff on coding and documentation issuesEnsures assigned projects are completed in a timely mannerCoordinates own travel arrangements with CHS facility and Corporate Travel Department, when neededAssists CHS affiliated providers with coding and documentation issues as they ariseMaintains strict confidentiality of provider information, patient data as well as financial and billing dataReports noncompliance issues detected through auditing and monitoring to the department DirectorComplies with all policies and procedures of the Corporate Compliance ProgramAttends meetings as requested, this may occasionally necessitate working in the eveningsPerforms related work as assignedAssists with special projects as assigned by the Director of Physician Coding, Documentation and ComplianceWorks with other staff members to inspire teamwork and promote cooperationOther duties as assigned

Education/Experience:

High school diploma or GED requiredAssociates Degree preferredRequires extensive, current knowledge of CPT, HCPCS, ICD-10-CM coding, medical terminology and AMA and CMS Documentation GuidelinesMinimum of five (5) years of experience in physician offices or clinics working with diagnostic and procedure coding and/or medical billingPossess a vast knowledge of current CPT, ICD-10-CM and HCPCS coding and reimbursement issues for physician office’s and clinicsPossess basic knowledge on Hierarchical Condition Category (HCC) coding and compliant physician queries.Strong knowledge of current AMA and CMS Evaluation and Management Documentation guidelinesExcellent understanding and comprehension of medical terminology

Certificates and Licenses: CPC, CCS-P, or CBCS

Physical Demands:
In order to successfully perform this job, with or without a reasonable accommodation, the following are outlined below:

The Employee is required to read, review, prepare and analyze written data and figures, using a PC or similar, and should possess visual acuity.The Employee may be required to occasionally climb, push, stand, walk, reach, grasp, kneel, stoop, and/or perform repetitive motions.The Employee is not substantially exposed to adverse environmental conditions and; therefore, job functions are typically performed under conditions such as those found within general office or administrative work.