Professional Fee Coding Educator

Job Summary

The Professional Fee Coding Educator provides training and education to CHS-affiliated providers and staff on accurate coding and documentation to ensure compliance with federal, state, and local laws. This role involves conducting educational sessions, performing compliance reviews, and creating educational materials to promote adherence to regulatory standards and organizational policies.

Essential Functions

• Conducts training sessions, seminars, and educational meetings for CHS-affiliated providers and staff, including the PPS Physician Coding and Documentation Seminar.
• Reviews medical records to ensure accurate coding and documentation of evaluation and management services, procedures, and other physician work in compliance with Medicare, Medicaid, and other payer requirements.
• Identifies and communicates educational needs to providers and coding staff, offering guidance on documentation and coding improvements.
• Assists in developing, updating, and maintaining educational materials and resources to support compliance with coding and documentation regulations.
• Remains current on legislative and regulatory changes impacting coding, documentation, and compliance, and updates staff and providers accordingly.
• Collaborates with CHS-employed clinicians, coders, and ancillary staff to address documentation and coding issues, ensuring best practices and compliance.
• Prepares comprehensive reports of compliance reviews, including recommendations for improvement, and presents findings to management, providers, and coding teams.
• Maintains strict confidentiality regarding provider information, patient data, and financial records, ensuring compliance with organizational policies.
• Reports noncompliance issues identified through audits and reviews to the department manager, director, or senior director.
• Coordinates travel arrangements as necessary to fulfill job responsibilities, adhering to organizational travel policies.
• Performs other duties as assigned.
• Maintains regular and reliable attendance.
• Complies with all policies and standards.

Qualifications

• H.S. Diploma or GED required
• Bachelor's Degree in Healthcare Administration, Business Administration, or a related field preferred
• 2-4 years of experience in medical coding, documentation, or healthcare compliance required
• 4-6 years of experience in a physician office/clinic working with evaluation management, diagnostic and procedures coding, and/or medical billing preferred

Knowledge, Skills and Abilities

• In-depth knowledge of coding and documentation guidelines, including CPT, ICD-10-CM, and HCPCS coding systems.
• Familiarity with Medicare, Medicaid, and payer-specific regulations and requirements.
• Strong presentation and communication skills to effectively educate providers and staff.
• Ability to analyze medical records and identify compliance risks and improvement opportunities.
• Proficiency in developing and maintaining educational materials for coding and documentation.
• Excellent organizational and time-management skills to handle multiple projects and deadlines.
• Ability to travel as required for training and educational sessions.

Licenses and Certifications

• Certified Coder-AHIMA or AAPC or equivalent preferred
• CCS-Certified Coding Specialist preferred