Senior Professional Coding Integrity Educator

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Shriners Children’s is an organization that respects, supports, and values each other. Named as the 2025 best mid-sized employer by Forbes, we are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster a learning environment that values evidenced based practice, experience, innovation, and critical thinking. Our compassion, integrity, accountability, and resilience define us as leaders in pediatric specialty care for our children and their families.

All employees are eligible for medical coverage on their first day! In addition, upon hire all employees are eligible for a 403(b) and Roth 403(b) Retirement Saving Plan with matching contributions of up to 6% after one year of service. Employees in a FT or PT status (40+ hours per pay period) will also be eligible for paid time off, life insurance, short term and long-term disability and the Flexible Spending Account (FSA) plans and a Health Savings Account (HSA) if a High Deductible Health Plan (HDHP) is elected.

Additional benefits available to FT and PT employees include tuition reimbursement, home & auto, hospitalization, critical illness, pet insurance and much more! Coverage is available to employees and their qualified dependents in accordance with the plans. Benefits may vary based on state law.

Under the direction of the Revenue Integrity Professional Coding Manager, the Senior Professional Coding Integrity Educator ensures that codes representing current International Classification of Diseases, Most recent Revision, Current Procedural Terminology (CPT), and the Healthcare Common Procedure Coding System (HCPCS) accurately reflect documented services by applying a demonstrated advanced knowledge of anatomy, physiology and medical terminology as well as compliant coding rules and regulations, including medical necessity and modifiers.

The Senior Educator coordinates and develops curriculum for coders to develop critical thinking and problem-solving skills and can effectively create and present educational material to coders as well as to Providers. Leads providers’ education events to discuss overall audit results overview, identifying trends and action plans. Provides support or project management for any other related audit and coding initiatives and assists in other related responsibilities as required by executive leadership team.

Oversees the Professional Coding Education Team in creating, coordinating, and scheduling Provider education and monthly Coding Team education or 1:1 education sessions as necessary.

• Coordinate and conduct training and mentorship on provider-based coding and billing guidelines
• Responsible for creating Coding Blasts, Tip Sheets, Newsletters, Power Points, SHINE Modules and other educational resources
• Focus on potential documentation improvement opportunities and issues by specialty for Evaluation & Management (E/M) and surgical providers
• Train providers and coding staff on E/M and Surgical documentation requirements
• Coordinates development of documentation improvement educational materials for providers; coders and other clinical and non-clinical staff
• Perform face to face presentations
• Develop curriculum and training handbook and create presentations
• Perform quality assurance reviews to assess comprehension of training efforts and assure coding quality and integrity for clinical staff
• Follows coding guidelines and legal requirements to ensure compliance with federal and state regulations
• Identify trends in documentation deficiencies and communicates areas of improvement to leadership and/or providers
• Acts as a key liaison for the clinical staff as it relates to coding and compliance
• Interacts with physicians and other clinical staff regarding documentation issues relating to coding data integrity
• Actively participates in problem identification and resolution and coordinates resolutions between appropriate parties
• Acts as a Liaison between provider and Professional Coder
• Provide 1:1 education with providers and coders as needed

This is not an all-inclusive list of this job’s responsibilities. The incumbent may be required to perform other related duties and participate in special projects as assigned.

Required:

• 10 years of professional coding experience
• Experience with Surgery Coding Guidelines, E/M Coding Guidelines, CPT coding, ICD-10, modifiers, HCPCS and Correct Coding Initiative (CCI) edits
• Pediatric, orthopedic and/or injury coding experience
• Experience with education and presentations to staff at all levels including senior leadership, providers and coding staff
• Epic EMR proficiency
• High School Diploma / GED
• Medical Coding Certificate: CCS through AHIMA or CPC through AAPC

• Associate's degree or higher