Physician Educator III

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Day - 08 Hour (United States of America)

This is a Stanford Health Care - University Healthcare Alliance job.

A Physician Educator (Professional Billing Coding and Documentation Educator) provides training and education on proper documentation and coding practices, ensuring compliance with regulations and standards. They play a vital role in healthcare settings by educating providers and clinicians, reviewing coding accuracy, and staying updated on evolving guidelines.

The responsibilities consist of evaluation of the adequacy and accuracy of documentation in support of services billed, including ICD-10, CPT/HCPCS and other third-party payer codes, the medical necessity of services provided, and the compliance with other documentation, coding and billing standards. This position provides training, consultation, review and feedback to clinicians on their medical service documentation and coding to ensure that SMP clinics receive appropriate reimbursement and conforms to applicable guidelines and regulations.

Stanford Health Care - University Healthcare Alliance

• Physician Education
• Training and
  
  Education:
  
  Conducting training sessions for physicians, staff, and other providers on coding and clinical documentation guidelines.
• Quality Assurance:
  Performing coding quality reviews, analyzing findings, and providing feedback to improve accuracy and compliance.
• Staying Current:
  Keeping up to date with the latest coding guidelines, regulations, and industry best practices.
• Documentation Review:
  Analyzing medical records to ensure accurate and complete documentation for billing purposes.
• Communication:
  Effectively communicating complex coding and billing information to diverse audiences.
• Collaboration:
  
  Working with various stakeholders, including physicians, coders, billers, and other healthcare professionals.
• Provide education to new providers and clinicians during their on-boarding period. This is a collaboration with SHC Office of Compliance and Privacy.
• Provides support to new and existing SMP sites by providing in clinic support to staff and Physicians to ensure compliant coding and documentation and use of Epic EMR.
• Provides on-site specialty specific training to individuals or groups of clinicians regarding documentation of services and appropriate coding of level of service, diagnoses, and procedures; including tips and techniques to help clinicians work more efficiently in Epic.
• Education and Specialty Workshops
• Performs requested clinical coding reviews to ensure accuracy of medical coding and documentation. Ensures that the clinicians use clinical expertise and judgment to determine correct coding & billing.
• Creates and publishes monthly Coding Corner Newsletter through the organization’s communication structure.
• Creates and educates through specialty workshops, in collaboration with medical group clinicians.
• Risk Adjustment Education
• Educates and guides healthcare providers and staff on accurate clinical documentation and coding practices, particularly concerning Hierarchical Condition Categories (HCCs) and risk adjustment methodologies.
• Reviewing medical records to ensure accurate HCC coding and identify opportunities for recapture and suspect diagnoses.
• Evaluating medical records to verify that documentation meets industry standard criteria (i.e., M.E.A.T.) to support the submitted diagnosis codes.
• Providing feedback and education to providers on coding review findings and documentation improvement.
• Developing and delivering training materials on risk adjustment coding and documentation best practices.
• Collaborating with other departments to address coding updates and support risk adjustment programs.
• Compliance
• This is a collaboration with SHC Office of Compliance and Privacy.
• Assist with the implementation of emerging coding and compliance laws and regulations and assist with implementing privacy policies. Development and implementation of coding education.
• Maintain current knowledge of coding…