Coder Educator

Job Details

933 Plaza MSO - Pleasanton Rd. - San Antonio, TX

Full Time

Revenue Cycle

Description

General Summary: The Coding Educator is responsible for the development, management, and oversight of a comprehensive coding program encompassing all activities of the organization. This position serves as the documentation and coding liaison to clinicians, ensuring compliance with government and organizational policies and procedures.

Supervisory Responsibilities: This position has no supervisory responsibilities.

General Requirements: All duties performed will be done accurately and in a timely manner.

Ensures customer service is always maintained at the highest level.

Exercise tact and courtesy when dealing with patients, visitors, providers, and co-workers.

Must always adhere to customer service expectations including in-person and virtual (via telephone, or telehealth applications) communication.

English and Spanish proficiency preferred.

Strong organizational skills are a requirement in this position.

Assist with special projects as needed.

Other duties as assigned.

Essential Job Responsibilities:

Perform consultative services to physicians and staff on complex coding issues.

Conduct a quarterly/annual review of each clinician in assigned specialties to identify areas for improvement in clinical documentation and coding, providing necessary education.

Assist in determining educational needs based on documentation reviews, provider/staff feedback, and data analysis.

Research errors related to coding or missed documentation, providing accurate coding guidance to support established processes.

Prepare necessary reports and communicate audit results to management, clinicians, and committees as appropriate.

Assist with development and refine maintenance of a comprehensive audit/oversight program.

Stay current with CPT-4, ICD-10, and HCPCS codes, communicating changes effectively to physicians and staff.

Develop comprehensive training and education programs for physicians and staff on coding rules and guidelines. (should this specifically call out ‘new providers’ too?)

Assist with development of performance standards for productivity and accuracy for new hires and established coders, establishing benchmarks and goals for coding accuracy.

Monitor and trend dashboard summaries to assess problems, issues, or areas of concern, preparing appropriate reports.

Develop standardized processes and procedures for overall consistency.

Establish or participate in regular meetings and open forum discussions on coding issues and concerns.

Develop and create solutions to reduce denial rates due to coding inaccuracy and improper documentation.

Provide GMG-sponsored access to workshops/audio conferences/seminars. Offer coding resource links/subscriptions/periodicals/materials providing updates and laws governing coding and documentation. Provide information on coding certification programs.

Assist in determining coding structure and needs in conjunction with EMR implementation from a correct coding standpoint.

Will need to travel to support patient care at another GMG location.

This position will require driving a company vehicle or a personal vehicle; therefore, employees must successfully complete a motor vehicle history check, possess, and maintain a current valid Texas Driver License, and proof of current insurance to be subject for mileage reimbursement.

Maintain strict confidentiality.

Work Environment: Depending upon the area assigned, may be 100% clinical setting or office setting in a clinical environment. Exposure to communicable diseases, bodily fluids, toxic substances, ionizing radiation, medicinal preparations, and other conditions common to a clinic environment. On-site work outside. Works in conditions of heat, cold, wet, dust, rain.

Mental / Physical Requirements: Requires manual dexterity, sitting, standing, stooping, reaching, kneeling, crouching, bending, walking, lifting up to 15 lbs. without assistance. Close vision and ability to adjust focus. Must be able to work efficiently under pressure.

Additional Information: Gonzaba Medical Group is seeking team members who contribute as A-Players, demonstrate a strong work ethic, are committed to the culture and our core values.

Other Duties As Assigned: The above job description is not intended to be an all-inclusive list of duties and standards of the position. Team members will follow any other instructions, and perform any other related duties, as assigned by their supervisor. Responsibilities, knowledge, skills, abilities, and work environments may change as needs evolve.

Qualifications

Education and Training: Minimum high school education or equivalent. Certified coder through AAPC or AHIMA; COC or CPMA required.

Experience:

Minimum of five years of coding experience required, multi-specialty and evaluation & management coding experience preferred.

Minimum of three years of experience performing audit/review/education functions for professional fees in multi-specialty setting preferred.

Broad knowledge of health care compliance and insurance billing guidelines and rules.

Strong communication skills to interact positively with physicians, patients, and staff.

Ability to write policies, procedures, and routine correspondence.

Analytical, summarization, and troubleshooting skills.

Other Requirements: Computer Skills: Knowledge of word processing software, spreadsheet software; internet software and database software.