Job description
JOB SUMMARY: The Coding Educator & Audit Specialist will establish and implement policies and procedures to improve coding and documentation within Blue Ridge Medical Group. They will educate providers and teammates on coding guidelines and accurate data capture to optimize reimbursement. They will oversee the capture of hierarchical condition categories through patient assessment forms and suspect condition forms. They will perform chart audits and provide feedback to the practice manager and provider. Specific job duties include coding and abstracting specific medical record types to gain proficiency in all medical record types while meeting/exceeding established quality and productivity standards. Performs other duties as assigned.
ESSENTIAL FUNCTIONS:
- Responsible for coding and abstracting patient records utilizing the ICD-10-CM and/or CPT-4 classification systems in conjunction with required software.
- Establish coding guidelines for accurate data capture and optimal reimbursement and work with providers to provide education in this area.
- Ensure targets are achieved with insurance payers and knowledgeable on quality metrics
- Reviewing and implementing coding guideline changes as updates are received
QUALIFICATIONS:
Education: Bachelor degree in healthcare related field with 2 years experience related to coding/auditing; Associate degree in healthcare related field with 4 years experience coding/auditing experience; or high school diploma with 7+ years of coding/auditing experience.
Experience: Minimum two years experience in a medical physician office facility
Minimum four years in medical practice billing, coding and collections
EPIC experience a plus
License/Registration: Certification through AAPC (American Academy of Professional Coders) Certified Professional Coder (CPC) required, Certified Risk Adjustment Coder (CRC) certification a plus.
Other: Advance knowledge of ICD-10-CM and CPT-4 classification systems/coding guidelines; advance knowledge in risk indicators CMS and HHS models; excellent interpersonal skills; possess excellent verbal and written communication skills; must be proficient with basic office equipment, must be able to commute between practices; knowledge of performance improvement, teaching/learning principles helpful; able to think critically and creatively to positively problem solve; able to meet turnaround times, productivity and quality standards.
TYPICAL PHYSICAL DEMANDS: Requires range of motion within functional limits. Functional vision and hearing, eye/hand coordination and manual dexterity. Occasional bending, stooping/kneeling, walking/standing. Frequent sitting. Lift/carry objects of 20 pounds.
Location: UNC Health Blue Ridge · Physician Practice Management
Schedule: Full Time, 1st Shift, M-F 800am-500pm, Hybrid 50% Remote
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