Coding Educator-Auditor

About the role

The Coding Educator-Auditor provides formal and informal coding and regulatory education/training to Providers and Professional Coders. The education will include coding and documentation requirements as directed by Federal and State requirements as well as the AMA. This position serves as a liaison between providers and coders. The Regional Business Office Physician Coding Team is responsible for the accurate and timely coding of the Samaritan Health Services clinic providers according to all applicable guidelines with applicable federal/state rules and regulations.

Schedule

This is a hybrid position that will work from home and within the clinics providing training to providers.

Responsibilities

• Reviewing (auditing) professional charges, medical records, and claims to ensure accuracy and compliance with CMS guidelines as well as CPT, HCPCS, ICD-10 coding guidelines.
• Identifying errors, inconsistencies, and areas for improvement in coding and documentation with current guidelines and regulations.
• Compiling and presenting reports of audit results, highlighting areas for improvement, educating, and reauditing.
• Answering coding questions for clinic managers, providers, and other staff.

Requirements

• High school diploma or equivalent required.
• Two (2) certifications (CPC, CRC Risk adjuster, CPMA, CPCO compliance officer, or RHIT) required upon hire.
• Three (3) years experience in CPT EM leveling, ICD-10 diagnosis coding, HCC diagnosis coding, medical claims auditing, and provider education required.
• Experience with data analysis and report preparation required.
• Physical demands: Rarely (1 - 10% of the time) climbing stairs; Lift (Floor to Waist: 0"-36") 0-20 lbs; Lift (Knee to chest: 24"-54") 0-20 lbs; Lift (Waist to Eye: up to 54") 0-20 lbs; Carry 1-handed, 0-20 pounds; Bend forward at waist; Kneel (on knees); Stand; Walk - level surface; Rotate trunk standing; Reach - upward; Push (0-20 pounds force); Pull (0-20 pounds force); Sit; Carry 2-handed, 0-20 pounds; Rotate trunk sitting; Reach - forward; Manual dexterity hands/wrists; Finger dexterity pinch fingers; Grasp hand/fist.

Skills

• Strong knowledge of healthcare regulations and standards, including Medicare and Medicaid.
• Knowledge of coding and billing practices in healthcare.
• Strong problem-solving and critical thinking skills.
• Excellent