The Coding Quality and Education professional will provide retrospective health record reviews for key characteristics of high-quality clinical documentation for Hospital Medicine.
Primary Duties and Responsibilities:
- 20%: Perform retrospective health record reviews to identify gaps within the clinical documentation and educate providers.
- 20%: Demonstrate proficiency in hospital medicine documentation regulatory requirements to include but not limited to: Coding guidelines for professional fee-based coding: Evaluation and Management services, Procedures, and Diagnosis(es)
- 20%: Serve as coding liaison in a professional manner with billing partners and revenue cycle team
- 15%: Communicate documentation issues as it relates to acuity and coding opportunities
- 15%: Review and resolve billing exceptions as it relates to Evaluation and Management level of service, Procedures, Modifiers
- 10%: Follow and remain compliant with all policies and procedures, including continuing education requirements as it relates to query of clinical documentation
Knowledge and Experience:
- Licensure /Certification in coding (CPC, CCS-P, CCS, RHIA, RHIT) required
- Demonstrate knowledge of 1995 and 1997 Evaluation and Management Documentation Guidelines and other professional documentation requirements
- Minimum of 2-3 years of experience auditing medical charts and coding required
- Demonstrate advance knowledge of hospital medicine coding and/or auditing
- Job Knowledge: Understands the expectations of the position and consistently meets the objective of the role
- Computer experience in word processing and excel
- Productive: Completes assigned charts and reports correctly and within time allowed
- Communication: Keeps team informed and promotes open communication
- Problem Solving/Decision Making: Uses sound judgement to gather and analyze information in accordance with American Physician Partners Policies
- Travel – light as needed to local facility; remote
- Ability to sit for long periods of time throughout day.
- Ability to work at a computer for 8+ hours.
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Note: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.
*INTERNAL CANDIDATES: To be considered for an open position, you must be in good standing (i.e., not on a Performance Improvement Plan) and in your current position for at least six months. You must also meet the minimum requirements for the job and be able to perform the essential functions of the position.