Coding Education and Quality Specialist

Job Duties

Park Nicollet is hiring a Coding Education and Quality Specialist. The Coding Education and Quality Specialist is a highly visible position that is responsible for partnering system wide with Clinicians and clinic operations staff to support the HealthPartners Revenue Cycle. This role is responsible for understanding revenue cycle workflow, identifying opportunities to ensure all appropriate revenue is captured, and assist in closing documentation gaps for clinical departments supported by the professional coding team.

Must have an in-depth understanding of coding and compliance rules and regulations and knowledge of the Electronic Health Record (EHR). Will provide system wide support to Clinicians, clinical departments, and coders for CPT, HCPCS, ICD-10 CM coding systems and payor policy guidelines.

MINIMUM QUALIFICATIONS:

Education, Experience or Equivalent Combination:

Must have completed a coding education program or must be a graduate from an associate or bachelor's degree program in health information.

Licensure/ Registration/ Certification:

Must have one of the following RHIT (registered health information technician), RHIA (registered health information administrator), or coding certificate. Coding certificates can include: CCA (certified coding associate), COC (certified outpatient coder), CCS (certified coding specialist), CPC (certified professional coder), CCS-P (certified coding specialist-physician).

Knowledge, Skills, and Abilities:

Knowledge in using CPT, HCPCS, ICD-10 CM coding guidelines, rules and regulations, anatomy, physiology, basic disease processes and medical terminology

Intermediate knowledge of Microsoft Office Suite. Ability to create excel spreadsheets and pivot tables for reporting and data analysis.

Must be able to work independently, apply time management and critical thinking skills, and have strong decision-making skills.

Must be a highly skilled and experienced coder who can independently research, analyze and understand large amounts of data, identify issues that have financial impact and provide opportunities to improve coding quality.

Ability to present information in one-on-one and/or group settings and communicate information in a professional and confident manner.

Must have a thorough understanding of revenue cycle stream.

PREFERRED QUALIFICATIONS:

Education, Experience or Equivalent Combination:

Three years coding experience

Epic experience preferred

Experience working with online coding resources and other related software programs.

Strong E & M coding experience

Licensure/ Registration/ Certification:

N/A

Knowledge, Skills, and Abilities:

Ability to present and communicate information in either individual and/or group settings in a professional and confident manner.

ESSENTIAL DUTIES:

(75%) - Ensures all services provided are accurately documented in the medical record and billed appropriately. This is accomplished using the following methods:

One-on-one chart review with clinician and/or departments as needed. Provide feedback based on identified coding trends.

Review coding practices for clinical departments and prepare summaries of revenue opportunities based on a detailed analysis.

In-depth understanding of EMR in the areas of charting tools such as templates, order entry, smart sets, and overall charge capture process flow.

Identify revenue opportunities through various methods such as the review of data, charge reconciliation reports and clinician documentation.

Proposes front end charge improvements as needed and provide education & feedback to coders, clinicians and clinic departments for denials that impact revenue flow and or capture.

Attends clinic department meetings to communicate and distribute coding and documentation information. Partners with clinic departments regarding clinical documentation improvements and/or other educational opportunities.

Partners with clinicians and coding teams for customer service issues.

Create and provide educational material to new onboarding clinicians. Ex: New Clinician Orientation recorded videos, tip sheets, virtual Q&A, etc.

(5%) - Independently performs root cause analysis and oversee volume and dollars for coding denials working directly with third party payors to understand policies and capture appropriate revenues. May provide direction and assistance to the coding teams working denied charges.

(5%) - Provides coding education (HCPCS, ICD-10 CM, DSM5, & CPT) to coders, clinicians, and clinic departments. Works with Compliance Operations to support the annual monitoring work plan. Partners with Diagnosis Accuracy Team to support risk adjustment requirements, diagnosis accuracy tools and collaborate with HealthPartners Health Plan to optimize diagnosis coding.

(5%) - Performs coding quality reviews for coding staff and provides education/feedback in partnership with coding leaders. Leverage EMR technology to create revenue capture solutions or make suggestions on operational changes.

(5%) - Attends coding related meetings (Ex: Coding Support Committee), and other department meetings when required and participates in creating/revising coding policies, procedures and/or education materials. Become familiar with clinic department operational processes or practices, and partner on improvement opportunities.

(5%) - Performs other duties as assigned.

*Job description rankings/percentages are intended to reflect normal averages over an extended period of time, and are subject to daily variances. Quality and efficiency standards should at no time be compromised to meet the average expectations expressed above. Job descriptions are subject to change to accommodate organization or department needs.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

Minimum Education Required

Bachelor Degree

Minimum Experience Required

3 - 20 years

Shift

First (Day)

Number of Openings

1

Public Transportation Accessible

Yes

Veterans Encouraged to Apply

No

Physical Required

Yes

Drug Test Required

Yes

Compensation

$11.41 / Hourly

Postal Code

55440

Job Type

Full Time

Place of Work

On-site

Requisition ID

121996

Job Benefits

Not specified