Under the direction of the Revenue Integrity Director, the Professional Coding Integrity Educator ensures that codes representing current International Classification of Diseases, 10th Revision (ICD-10), Current Procedural Terminology (CPT), and the Healthcare Common Procedure Coding System (HCPCS) accurately reflect documented services by applying a demonstrated knowledge of anatomy, physiology and medical terminology as well as compliant coding rules and regulations, including medical necessity and modifiers.
POSITION RESPONSIBILITIES:
Focus on potential documentation improvement opportunities and issues by specialty for Evaluation & Management (E/M) and surgical providers
Train providers and coding staff on E/M and Surgical documentation requirements
Coordinates development of documentation improvement educational materials for providers; coders and other clinical and non-clinical staff
Perform face-to-face presentations
Develop curriculum and training handbook and create presentations
Perform quality assurance reviews to assess comprehension of training efforts and assure coding quality and integrity for clinical staff
Conduct training sessions on provider-based coding and billing guidelines
Follow coding guidelines and legal requirements to ensure compliance with federal and state regulations
Identify trends in documentation deficiencies and communicates areas of improvement to leadership and/or providers
Act as a key liaison for the clinical staff as it relates to coding and compliance
Interacts with physicians and other clinical staff regarding documentation issues relating to coding data integrity
Actively participate in problem identification and resolution and coordinates resolutions between appropriate parties
Liaison between provider and Professional Coder
THE QUALIFIED CANDIDATE WILL HAVE EXPERIENCE IN THE FOLLOWING AREAS :
10 years of professional coding experience required
Experience with Surgery Coding Guidelines, E/M Coding Guidelines, CPT coding, ICD-10, modifiers, HCPCS and Correct Coding Initiative (CCI) edits required
Pediatric, orthopedic and/or injury coding experience required
Experience with education and presentations to staff at all levels including Senior Leadership, providers and coding staff required
Effective communication and interpersonal skills with ability to work with clinical and non-clinical staff regarding coding issues
Strong problem solving, collaboration and interpersonal skills required to facilitate adherence to education plans
MINIMUM EDUCATION REQUIRED/PREFERRED :
High School Diploma or GED required
Medical Coding Certificate (CCS through AHIMA or CPC through AAPC) required; meet state licensure requirements
Associates Degree or higher preferred
KNOWLEDGE, SKILLS, AND COMPETENCIES :
Effective communication and interpersonal skills with ability to work with clinical and non-clinical staff regarding coding issues
Strong problem solving, collaboration and interpersonal skills required to facilitate adherence to education plans
Functional knowledge of Microsoft computer applications; excel, word, PowerPoint, etc.
Functional knowledge of 3M system or other encoder programs
Functional knowledge of Medical Terminology
Functional knowledge of professional coding practice standards
Proficient with E/M and surgical code assignment
Proficient with ICD-10 diagnosis code assignment
Proficient with CPT 4, HCPC and modifier codes
Excellent written, verbal and presentation skills
Participation in continuing education and learning experiences to enhance and maintain current knowledge and skills for continued competence
Accurate and precise attention to detail
Ability to multitask, prioritize and manage time efficiently
Recommended skills
Cpt Coding
E/M Coding
Education And Presentations
Orthopedic And/Or Injury Coding
Pediatric Coding
Surgical Coding
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Job Snapshot
Employee Type
Full-Time
Location
Tampa, FL, FL
Job Type
Health Care
Experience
10 years
Date Posted
02/18/2021
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Tampa, FL
Shriners Hospitals for Children is a network of 22 non-profit medical facilities across North America. Children with orthopaedic conditions, burns, spinal cord injuries, and cleft lip and palate are eligible for care and receive all services in a family-centered environment, regardless of the patients' ability to pay.
Headquartered in Tampa, Florida, the hospitals are owned and operated by Shriners International, formerly known as the Ancient Arabic Order of the Nobles of the Mystic Shrine, a Freemasonry-related organization whose members are known as Shriners. Patients must be minors under the age of 18 and are not required to have any familial affiliation with the Shriners order nor Freemasonry. The current[when?] advertising campaign for the healthcare system features the tagline, "Love to the Rescue