Coding Educator

Responsibilities

• Reviews and/or assigns proper CPT procedures and/or diagnosis codes (ICD-10-CM including HCC risk adjustment diagnosis) for professional services including specialty medical services, in and outpatient E&M, and surgical procedures (i.e., cardiology, orthopedic, and general surgery) with a high degree of accuracy.
• Educates providers on documentation improvement opportunities. Conducts and reports internal documentation audits to ensure Theda Care compliance by providers and team members.
• Performs internal reviews in response to third party data summaries and/or investigations. Creates mitigation plan to reduce future risk.
• Manages and maintains coding inventory responsibilities, internal reporting and payer denials, and claim edits to ensure timely reimbursement for services provided. Researches policy and communicates with payers.
• Mentors and trains team members to skills matrix requirements. Provides orientation training to new team members.
• Performs world class service to our customers, responding timely and professionally to inquiries.

• High School diploma or GED preferred
• Must be 18 years of age
• Coding certificate or associate’s degree in medical business or coding/health information
• Three years of experience in general medical or specialty coding
• Dual certifications through AAPC and/or AHIMA

Ability to move freely (standing, stooping, walking, bending, pushing, and pulling) and lift up to a maximum of twenty-five (25) pounds without assistance

Job classification is not exposed to blood borne pathogens (blood or bodily fluids) while performing job duties

Normally works in climate controlled office environment

Frequent sitting with movement throughout office space

Use of computers throughout the work day

Frequent use of keyboard with repetitive motion of hands, wrists, and fingers