To provide professional service assistance to the Lead Coding Educator & Coding Educators as it relates to, consultation, audit & feedback to clinicians on their documentation & coding to ensure the KPMAS receives appropriate reimbursement & conforms to applicable guidelines & regulation. This position is a supportive role to that of the Lead Coding Educator & Coding Educators.
Essential Functions:
- Performs daily surveillance of encounters performed in locations external to KPMAS MOBs to ensure charges entered into the KPHC charging system are valid. Verifies the accuracy, completeness, & precision of ICD-9-CM, CPT-4, & HCPCs coding, including modifiers, units, & other variables impacting workload accountability & billing. This requires independently re-coding the encounter from source documentation, completing supporting worksheets documenting rationale for coding decisions, recording discrepancies, & recording the rationale for changes in codingdecisions.
- Provides External Service Capture training to clinicians on documentation of services & appropriate coding of level of service (CPT-4), diagnoses (ICD9-CM), procedures (CPT-4) & HCPCS coding associated w/ charge capture w/ potential to impact workload accountability & billing. This covers settings external to that of KPMAS MOBs.
- Maintains current knowledge to ensure that KPMAS coding & documentation meets regulatory guidelines & audit standards & results in appropriate reimbursements. Maintains professional competency in professional services coding & documentation requirements.
- Collaborates w/ the Coding Educators team to develop & implement strategies to make appropriate documentation & coding easier for clinicians.
- Present providers w/ training materials & information derived from audit findings as instructed by Lead Coding Educator, for feedback to physicians.
Qualifications:
Basic Qualifications:
-2 years of experience in a health care setting is required.
- 2 years of coding experience is required.
- 2 years of medical terminology required.
- 2 years of customer service experience is required.
- 2 years of knowledge in coding practices is required.
- High School diploma is required.
- CPC or CCS-P is required.
- 2 years of knowledge of compliance & regulatory requirements is required.
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.