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Responsible for overall management of coding education, tri-campus, including MS-DRG assignments, diagnosis, and procedure coding.
RIMARY DUTIES AND RESPONSIBILITIES
1. Serves as primary educator for Department staff and works directly with the Manager. Provides coding education using adult learning methodologies to coders, medical staff and others regarding highly complex documentation, reimbursement and data interpretation for inpatient, outpatient and professional service coded data. Provides one-on-one and classroom education as assigned. Acts as a coding expert resource. Conducts the quality review of inpatient, outpatient and/or professional service coding; maintains up-to-date coding guidelines and coding policy changes. Develops process improvement activities based on audit results, trend analysis, etc. in partnership with the Internal Audit team as well as Revenue Integrity and/or HIM team.
2. Administer, implement and update the overall coding (Inpatient and Outpatient) education program for Shared Services coders.
3. Actively works with the Manager of Coding (and/or other members of those teams) to identify areas where focused education may be needed for all production coders and subsequently develops the curriculum and plan for educating all coders.
4.Administers curriculum for coders to acquire the knowledge and skills necessary for competency.
5. Administers curriculum for newly hired coders to ensure proficiency and quality meets company standards.
6. Provides "real world" coding experience for all coders prior to releasing any coder for production work.
7. Lead training sessions on current billing and coding information in the medical field.
8. Develop curriculum and training handbook and create presentations.
9. Perform quality assurance reviews to assess comprehension of training efforts and assure coding quality.
10.. Review and respond to coding questions.
11. Research updated coding information and communicate changes to physicians and billing staff.
11. Provide continual coding and payer updates.
12. Maintain knowledge of (ICD-10) and CPT classifications and coding of diagnoses and procedures.
13. Identify elements of a medical record's structure and content and code abstracting.
14.. Convert hand-written medical charts to code.
15.. Works closely with physicians to ensure that charges are being accurately and compliantly being captured, coded, and billed compliantly.
16 Builds strong relationships and facilitate effective communication between hospital and physician-based practices.
1717. Supervises Coding Quality Specialists II and I including the following functions:
A. AHRQ review
B. Pre-bill review
C. CDI discrepancies
KNOWLEDGE SKILLS AND ABILITIES/LICENSE OR CERTIFICATION REQUIRED
1. A minimum of 7 years of experience in a clinical environment (hospital inpatient, outpatient or integrated healthcare delivery system) coding role involving the accurate interpretation and coding/abstraction of therapeutic/diagnostic measures and procedures of a diverse patient population such as a coder, coding auditor or coding instructor.
2. If Associate’s degree, a minimum of 5 years of experience required; if Bachelor’s degree, a minimum of 4 years of experience required. 3. CPC (Certified Professional Coder) through AAPC (American Academy of Professional Coders), PCS (Professional Coding Specialist) or CCS (Certified Coding Specialist) through AHIMA (American Health Information Management Association), RHIT (Registered Health Information Technician), and/or RHIA (Registered Health Information Administrator) current certification required.
4. Coding certification through a nationally recognized and accredited health information association required.
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