What will you do?

The HCC Compliance Educator, reporting to the Director of Compliance, manages the HCC coding and compliance education for providers and staff; develops and delivers training/education in a variety of formats; assists with external payer audits, reviews reports and performs analyses to determine key areas of educational need; and performs HCC compliance audits as assigned.

Duties and Responsibilities include but are not limited to:

• Performs analyses using QLIK and other internal applications to develop and deliver comprehensive physician coding and compliance education to physicians, residents, APPs and staff inclusive of all current regulations. Such materials include but are not limited to using provider, division and/or department specific examples, and incorporation of regulations. Ensures educational methodology and approach is robust and progressive, and
  developed with application to the EMR, workflows, operations, clinical situations and/or scenarios.
• Provides chart reviews and clinical documentation improvement suggestions and advice to providers prior to the scheduled visit.
• Tracks education initiative(s) success inclusive of deploying assessments and measurements to improve training effectiveness. Monitors feedback to continuously improve training delivery, materials, and effectiveness.
• Creates and deploys coding and documentation education materials to providers.
• Performs CRC Coding duties to ensure timely submission of claims. Ensures competency of CRC Coding and Compliance Specialist team by performing regular coding audits and education to the CRC coding and Compliance team.
• Develops new HCC course content and upgrading existing content in partnership with departmental subject matter experts for live, online, and/or virtual delivery.
• Collaborates with various departments and Physician Champions to identify key areas for increased exposure and education, and then develops and delivers needed education.
• Researches and responds to any regulatory or compliance inquiries that may occur as a result of education sessions.
• Assesses themes from payer audit letters, and determining if system edits would assist, or in general reviewing top denials and applying the same concepts of creating edits to assist in prevention of denials
• Effectively communicates compliance and/or regulatory updates.
• Assists with education and onboarding of new employees within the compliance department as assigned. May audit compliance staff as assigned.
• Assists staff with education presentations, including new hire orientations, as needed.
• Maintains knowledge of CMS, State and/or Federal coding rules and regulations.
• Partners with Compliance Specialists and leadership to express compliance concerns/issues and potential corrective actions to Clinical Chairs and Administrators

What are we looking for in our next new hire?

High school diploma or equivalent. Certification as a CPC, CCS-P, RHIT or RHIA or may hire on the condition of obtaining certification within first two (2) years of employment. Five to eight years of experience with coding and reimbursement for physician services. Skill in establishing and maintaining effective working relationships with physicians and mid-level providers. Ability to communicate in writing. Effective training and public speaking skills. Interpersonal communication and facilitation skills. Knowledge of physician auditing practices and an in-depth knowledge of CPT, ICD-10-CM diagnosis codes and HCPCS procedure and professional supply codes used for billing services provided by physicians and non-physician providers. Knowledge of a variety of computer software applications in word processing, spreadsheets, database and presentation software (MSWord, Excel, Access, PowerPoint).

Preferences: Bachelor’s degree in business or health related field. Experience with various systems such as EPIC, EncoderPro, MD Audit. Experience in academic medicine. Experience with data visualization tools such as Qlik. Certified Risk Coder (CRC) Certification.

OSU Physicians, Inc.

What is OSU Physicians all about?

• We believe that being engaged and sharing in a larger purpose at work is instrumental to the employee experience. “Tradition, determination, teamwork, purpose, compassion, community, pride, integrity”….these are just a few words that our employees use to describe what it feels like to embody the “Buckeye Spirit” and work for our organization.
• We strive to create environments where our colleagues and all those we serve feel empowered to share their full, authentic selves.
• Our over 60 physician practices embody the spirit of teamwork with passionate care for our patients and each other. Our teams are diverse in employees, thoughts, and ideas bringing the full spectrum of a collaborative culture to the big picture – TEAMWORK!
• OSU Physicians focuses on entire patient experience, from the minute they call in for an appointment, to being welcomed in the office, and then receiving quality, compassionate, thorough care from our physicians and the entire OSU Physicians healthcare team.

Sound like something you are seeking in your next career adventure? We invite you to keep reading.

What do we offer?

Benefits! It's all about choices. We know that having options and robust benefit plans are important to you. That's why here at OSU Physicians, we offer our employees a flexible, competitive benefit package. Full-time benefits start for individuals working a minimum of 30 hours per week, as well as some benefits available to employees working as little as 20 hours a week. Some of our excellent benefits options and perks include:

• Diverse and Affordable Healthcare Choices: Coverage begins on your First Day of Employment; includes Medical, Dental, Vision and Prescription Drug Programs.
• Outpatient clinic settings with day shift hours, Monday through Friday.
• Generous Paid Time-Off: Allowing a true work-life balance starting at 17 days per year and 11 paid holidays.
• Competitive compensation and career ladder opportunities
• Retirement Plan: Company contribution of 7.5% to your retirement plan in which you are fully vested from your first day of employment.
• Flexible Spending Accounts (Healthcare and Dependent Care).
• Paid Parental Leave Program
• Tuition Reimbursement Program