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Provider Educator

South Shore Health
Posted a month ago, valid for 16 days
Location

East Weymouth, MA 02189, US

Salary

$55,000 - $66,000 per year

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Contract type

Full Time

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Sonic Summary

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  • The position at South Shore Health is for a Professional Coding Specialist with a salary range of $79,600.00 to $113,800.00.
  • Candidates should have more than three years of ICD10/CPT coding and auditing experience in acute care and medical specialty settings.
  • The role involves serving as a subject matter expert in coding documentation, providing feedback, and collaborating with various departments to address concerns.
  • Preferred qualifications include a bachelor's degree and certifications such as CCS or CPC with Certified Professional Medical Auditor.
  • This is a full-time position with a day shift from Monday to Friday, requiring continuous education to maintain coding proficiencies.

If you are an existing employee of South Shore Health then please apply through the internal career site.

Requisition Number:

R-21931

Facility:

LOC0014 - 549 Columbian Street549 Columbian Street Weymouth, MA 02190

Department Name:

SHS Physician Services Admin

Status:

Full time

Budgeted Hours:

40

Shift:

Day (United States of America)

Under the general direction of the Professional Coding Manager, this individual will serve as the subject matter expert and the key point of contact for evaluation and management, procedural CPT and ICD 10 coding documentation information for ProFee coding in the hospital and ASC setting. This person will provide feedback, charge capture concerns and offer suggestions for resolution.

Duties include Professional documentation & coding reviews, as well as, collaborating with Compliance and Physician Liaison to address documentation and coding concerns. Specific educational topics to include, but not limited to, documentation specificity requirements, selection of primary and specialty care E&M levels, selection of procedural charges and codes, diagnosis assignment, and modifier assignment to ensure correct coding, legal compliance and complete charge capture.

 

Compensation Pay Range:

$79,600.00 - $113,800.00

 

ESSENTIAL FUNCTIONS

1 - Professional Documentation & Coding: 

   a - Assess professional provider documentation and professional coding education needs by (1) collaborating with the Professional Coding Manager, SSMC Leadership, and Providers to obtain existing data, observations as relates to coding and documentation specificity and (2) by conducting ICD10, CPT, and HCPCS coding and provider documentation audits to evaluate specificity of documentation and corresponding accuracy of assigned diagnosis, procedure, and modifier codes.

b - Perform provider education using various communication tools and training platforms (e.g., in-person, on-line, one-on-one, and group).

   c - Summarize chart audit results, trends, and corresponding action plans. Distribute and present reports to SSH leadership.

   d – Present education for new providers and present as needed.

2. Professional Documentation and Coding

a - Collaborate with SSH leadership, Coders, Billing Staff, Physician Billing Managers and I.S to identify and provide feedback for any new processes, software, and Provider training opportunities based on audit results.

  b - Collaborate with PB Coding Manager to create educational presentations for HealthStream and/or webinars with providers on changing guidelines.

c - Perform post-presentation quality assurance reviews to assess comprehension of training efforts.

d - Stay updated on current coding information.

e - Communicate coding, billing and documentation specificity changes to providers.

f - Participate in regular meetings with PB Coding Manager and/or the Director of Revenue Integrity to communicate new findings and/or areas of concern.

g - Provide continual coding and payer update educationto providers.

  h - Maintain knowledge of E&M, HCPCS, modifier, ICD10 and CPT classification and coding of diagnoses and procedures.
i - Assist with developing and implementing recommendations for changes in policies and procedures relevant to correct and compliant provider documentation.
j - Serve as a resource for physicians, billing, coding, and administrative staff with regard to technical guidance on professional coding/documentation issues.
k - Complete required continuous training and education to maintain proficiencies.

JOB REQUIREMENTS

Minimum Education - Preferred

Equivalent to four (4) years of high school education. Bachelor's degree is preferred.

Minimum Work Experience

Greater than three (3) years ICD10/CPT coding/auditing experience in acute care and medical specialty setting is preferred.

Required Certifications

CCS - Certified Coding Specialist or CPC with Certified Professional Medical Auditor

Monday - Friday 7:30-4:00 salary may have different times

Responsibilities if Required:

Education if Required:

License/Registration/Certification Requirements:

Certified Coding Specialist - American Health Information Management Association (AHIMA), Certified Professional Medical Auditor (CPMA) - American Academy of Professional Coders (AAPC)



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