Job description

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Work Shift Day

Work Day(s) Friday, Monday, Thursday, Tuesday, Wednesday

Shift Start Time 8:00 AM

Shift End Time 4:30 PM

Worker Sub-Type Regular

Children’s is one of the nation’s leading children’s hospitals. No matter the role, every member of our team is an essential part of our mission to make kids better today and healthier tomorrow. We’re committed to putting you first, and that commitment is at the heart of our company culture: People first. Children always. Find your next career opportunity and make a difference doing what you love at Children’s.

Job Description Provides education in coding and billing compliance within Children’s Physician Group to physicians, physician assistants, nurse practitioners, and clinical service auxiliary providers to improve the workflow and promote overall clinical documentation improvement. Creates communication of important coding and billing information for administrative and finance leaders as it relates to their areas. Assists in the development of evaluation and management and other billing code utilization reports for comparison to national and peer-to-peer data. Supports the improvement of overall coding and billing practices of the physician professional services.

Experience

• Five years of experience in coding
• Strong knowledge base and experience in interpreting and applying federal/government regulations to ensure coding and documentation compliance

Preferred Qualifications

• Experience in physician practice coding

Education

• Graduate of approved health information technology or health information management program

Certification Summary

• Certified Professional Coder (CPC), Certified Professional Coder-Payer (CPC-P), Certified Coding Specialist (CCS), Certified Coding Specialist- Physician-based (CCS-P), or ability to obtain within three months of employment

Knowledge, Skills and Abilities

• Strong knowledge base in complete and accurate clinical documentation in all healthcare settings and for all healthcare disciplines
• Strong knowledge base of the conventions, rules, and guidelines for multiple classification and reimbursement systems (e.g., ICD -10, diagnosis-related group, and all patient refined diagnosis-related group)
• Demonstrated knowledge of medical terminology, anatomy and physiology, pharmacology, computers, and encoding software
• Demonstrated strengths in teaching and presentation skills
• Must be detail-oriented, possess good problem solving skills, and have legible handwriting
• Must be able to successfully pass the Basic Windows Skill Assessment at 80% or higher rating within 30 days of employment

Job Responsibilities
1.Provides appropriately messaged and continuous education and updates to physicians, advanced practice providers, and practice leadership regarding coding and billing practices to meet regulatory requirements and capture appropriate revenue.
2.Educates physicians and key healthcare providers regarding clinical documentation improvement and the need for accurate and complete documentation in the health record.
3.Educates assigned new physicians and advanced practice providers on coding needs specific to their specialty as part of the onboarding experience.
4.Performs shadowing services for billing providers and administrative staff to gather information and provide constructive input to operations and the billing provider to become more efficient in daily workflow and accuracy in charge selection supported by their clinical documentation.
5.Partners with Coding, Compliance, and other applicable departments on coding issues while coordinating review of open issues and monitoring until resolved.
6.Monitors coding resources and payer updates for issues that impact professional billing and reports to manager.
7.Develops tools as assigned that will assist providers, practice management, and office staff to meet regulatory requirements and capture all appropriate revenue.
8.Analyzes billing and denial information, claim error, and other data for potential coding and billing opportunities.
9.Summarizes and reports findings to manager and uses findings in educational trainings.
10.Understands post-billing review findings and assists in relaying constructive education for the purpose of improving deficiencies identified in the review.
11.Reviews and analyzes evaluation and management coding and other billing trend profiles to identify patterns that may provide clues requiring focus for further analysis, support, and/or education.
12.Reviews encounter forms, coding forms, or billing tool information at least annually, and recommends changes to codes and encounter form layout as necessary.

Primary Location Address Used for remote worker assignment

Job Family Coding

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