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Position Details

Department: CORP | Professional Svcs Coding
Category: Hlth Info Mgmt/Med Records
Location: Telecommuting
Posting #: 664229
Date Posted: 4/7/2022
Employee Type: Regular

Position Summary

The Lead Educator Professional Services Coding is a primary resource to the team to develop education process and templates; identify PCMG/PCP needs through industry engagement and data; provide technical and professional support as the team members grow proactive and professional relationships; create targeted education to optimize the quality and accuracy of provider documentation and billing opportunities. This position has the ability to resolve high complexity issues, acts as a subject matter expert and demonstrates leadership through education, coaching and process/tool development for the Education team. As a part of the Education development and in coordination with Phoenix Children`s Annual Compliance plan, this position is also responsible for performing education and audits of medical records for compliance with federal coding regulation and guidelines under direct supervision of the Manager of Professional Services. This position also assists with coding production, as needed; reviews and resolves coding issues related to billing; researches complex coding issues and participates in process improvements related to documentation, coding and EM management.

PCH Values

  • Family-Centered care that focuses on the need of the child first and values the family as an important member of the care team
  • Excellence in clinical care, service and communication
  • Collaborative within our institution and with others who share our mission and goals
  • Leadership that set the standard for pediatric health care today and innovations of the future
  • Accountability to our patients, community and each other for providing the best in the most cost-effective way.

Position Duties

  1. Assists Manager/Leadership with development and optimization of processes, tools, and templates - acting as a subject matter expert for implementation of change.
  2. Assists Manager/Leadership with monitoring activities and direction of resources to ensure successful progress of established coding and education plans.
  3. Ensures compliance with Federal Coding Documentation Guidelines and PCH/PCMG official coding policies.
  4. Performs internal coding and documentation quality reviews of coded Ambulatory services and professional fee assignment of medical records to verify the accuracy and specificity of assigned codes in accordance with documentation guidelines.
  5. Educates and Communicates with providers and coders regarding medical record documentation in order to maximize accuracy, completeness, and compliance with accepted standards of practice and current coding guidelines.
  6. Reviews accounts, when requested by the Physician Billing and Revenue Cycle Department and other clinical departments to research and resolve coding issues related to billing.
  7. Participates in continuing education activities to maintain current credentials, as well as to enhance knowledge and skills.
  8. Reviews Medical records for appropriate Diagnosis/EM/CPT/HCPCS codes and modifiers in compliance with Official Documentation Guidelines for Coding and Reporting as well as PCMG coding policies.
  9. Performs miscellaneous job related duties as requested.

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Position Qualifications

Please review the following qualifications and specify whether you meet each of the requirements listed.
Do you meet this requirement?
Education
1. High School Diploma or equivalent. Required
2. Associates Degree in Coding or related field Preferred
Do you meet this requirement?
Experience
1. Three (3) or more years of Physician E/M Auditing experience. Required
2. Comprehensive knowledge of ICD-10-CM Official Guidelines for Coding
Reporting, ICD and CPT/HCPCS coding classification systems, including facility and physician E/M, and hospital coding and reimbursement software.
Required
3. Previous experience interacting with external/internal coding staff, auditors and leadership. Required
4. Staff training/auditing experience in a healthcare setting. Required
Do you meet this requirement?
Certifications/Licenses/Registries
1. CPC, CCS-P, CCS or RHIT or other accredited Coding credentials through AAPC or AHIMA Required
2. CPMA or other accredited Auditing certification through and accredited source such as the AAPC or AHIMA Preferred
Do you meet this requirement?
Special Skills
1. Previous work with Auditing software. Required
2. Versed in regulatory requirements for medical record documentation, as well as Medical staff Rules and Regulations where applicable. Required
3. Medical Terminology and an understanding for the laws and regulations associated with medical records functions Required
4. Expert presentation skills, including experience and proficiency in virtual presentation tools (such as Zoom, Skype or Microsoft Teams) and computer skills including Microsoft Powerpoint and Microsoft Excel Required
Physical Requirements & Occupational Exposure/Risk Potential
1. Physical Requirement - Feeling (sensing textures and temperatures) Occasionally
2. Physical Requirement - Fine Motor Skills (pinching, gripping, etc) Frequently
3. Physical Requirement - Hearing Constantly
4. Physical Requirement - Pushing/pulling Occasionally
5. Physical Requirement - Reaching Occasionally
6. Physical Requirement - Sitting Frequently
7. Physical Requirement - Standing Occasionally
8. Physical Requirement - Talking Frequently
9. Physical Requirement - Walking Occasionally
10. Physical Requirement - Near Vision Occasionally
11. Physical Requirement - Far Vision Occasionally
12. Physical Requirement - Color Discrimination Occasionally
13. Physical Requirement - Use of keyboard, mouse and/or computer equipment Frequently
internal/external
I have reviewed the qualifications, physical requirements and occupational exposure/risk potential for this position and wish to apply