Coding Quality and Education Advisor

Description

Core Clinical Partners stands at the forefront of Emergency and Hospital Medicine, delivering unparalleled services through a model that emphasizes patient-centric care and operational excellence. Our corporate values – Genuine, Accountable, Dynamic, Respectful, and Fun – are the pillars that uphold our commitment to revolutionize healthcare delivery.

The Coding Quality and Education Advisor oversees the medical coding department, ensuring accurate and compliant coding practices that optimize revenue cycle performance.  

Essential Duties:  

Coding Operations 

• Ensure coding compliance with CMS, AMA, AHA, and payer-specific guidelines. 
• Oversee the coding of diagnoses, procedures, and services using ICD-10-CM, CPT, and HCPCS codes. 
• Review coding audits and implement corrective actions when necessary. 
• Review Medical Records for inconsistent coding practices and offer remediation solutions. 

Workflow & Process Improvement 

• Analyze and streamline coding workflows for efficiency and accuracy. 
• Utilize data analytics and reporting to identify trends, discrepancies, or training needs. 
• Participate in company-wide initiatives related to clinical documentation improvement. 

Collaboration 

• Liaise with physicians, clinical staff, billing, and revenue cycle teams to clarify documentation and resolve coding-related issues. 
• Support accurate clinical documentation improvement (CDI) efforts. 
• Perform ongoing outreach/education for new and existing clinicians for Emergency Medicine and/or Hospital Medicine documentation requirements using a variety of formats.  
• Advise and educate internal operations teams on documentation coding by participating in Monthly Facility/Team Meeting group sessions.  
• Participate in provider Electronic Medical Record (EMR) training and provide feedback/clarification on documentation and coding workflow concepts. 

Skills, Knowledge, Abilities:  

• Strong organizational skills with the ability to multi-task in a fast-paced environment.  
• Ability to adapt, modify and prioritize while adhering to strict deadlines and a willingness to shift priorities to meet the needs of the organization.  
• Knowledge and understanding of medical coding and billing systems and regulatory requirements. Knowledge of legal, regulatory and policy compliance issues related to medical coding and billing procedures and documentation. 
• Excellent communication and interpersonal skills and demonstrated ability to interact with a variety of team members. 
• Self-motivated with the ability to identify opportunities for improvement and demonstrate the initiative to resolve issues in support of improvement efforts.  
• Strong analytical skills and the ability to work independently to analyze and solve problems.  
• Adept at learning proprietary software applications. 
• Collaborate with professionals internal and external to the company and across geographic locations.  
• Exhibit growth mindset and team-orientated behaviors.  
• Navigate competing priorities and effectively work in a fast-paced environment.
  

Requirements

Education:  

• Preferred: RHIA, CDI, CPC, CCS, CCS-P 
• Bachelor’s degree or equivalent is required
   

Experience:  

• 3-5 years’ experience in Hospital or Physician practice environment desired. 
• Experience with Evaluation & Management coding; hospital medicine background preferred. 
•  EHR/EMR (Electronic Health Record/Electronic Medical Record) experience required. 
•  Chart Auditing/Optimization experience is a must