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Lakeland Regional Health-Florida · 3 weeks ago

Outpatient Coding Quality Education Specialist

Lakeland, FL

Full-time

Onsite

Mid, Senior Level

$64K/yr - $80K/yr

5+ years exp

Lakeland Regional Health is a leading medical center located in Central Florida, dedicated to providing high-quality care to its diverse patient population. The Outpatient Coding Quality Education Specialist is responsible for conducting coding quality reviews, developing training programs for coders, and ensuring compliance with coding regulations and best practices.

FitnessHealth CareNon Profit

Growth Opportunities

Responsibilities

Conducts coding quality reviews and audits of chart documentation to assess accuracy, ensure compliance with federal and payer policies, and identifies areas for improvement for hospital outpatient coding

Develops and delivers training on coding accuracy and compliance, staying updated on regulations and providing expert guidance to coders

Provides ongoing coding education and training to the coding team and serves as mentor to all new coding team members

Serves as a subject matter expert and resource for coders, providers, and other staff on coding questions, regulatory changes, and best practice

Prepares reports of findings and meets with coders and Coding Leadership to provide education and training on accurate coding practices and compliance issues

Responsible for conducting coding and billing training programs for billing and coding specialists

Implements coding department policies and procedures and assists with reviewing and appealing coding denials

Actively participates in team development, achieving dashboards, and in accomplishing departmental goals and objectives

Performs internal quality assessment reviews on outpatient facility coders to ensure compliance with national coding guidelines and the LRH coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity

Helps to coordinate and direct the day-to-day coding educational activities

Facilitates and provides coding educational classes/presentations to staff, as required/when needed

Communicates outcomes to the coding team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments

Assists Coding Leadership in root cause analysis of coding quality issues, performing account reviews, and preparing training documents to assist with coding quality action plans

Assists in the review, improvement of processes, education, troubleshooting and recommend prioritization of issues

Researches coding opportunities and escalates as needed

Communicates Coding topics and/or question trends to Coding Leadership for global education

Prepares and presents coding compliance status reports to the Coding and Reimbursement Manager and Health Information Management AVP

Assists in ensuring coding staff adherence with coding guidelines and policy

Demonstrates and applies expert level knowledge of medical coding practices and concepts

Coaches and mentors coding staff as they develop and grow their coding skills

Provides skilled coding support through regularly scheduled coding meetings and as the need arises

Provide one-on-one coaching and support to coding professionals, offering constructive feedback and guidance to improve coding accuracy and documentation practices

Assists Coding Leadership with outpatient coding denials

Creates educational materials, such as manuals, handouts, and multimedia presentations, that effectively communicate complex coding concepts and guidelines

Orients, develops and coordinates on-the-job training of instructing them on systems and policies and procedures in accordance to coding compliance guidelines

Qualification

ICD-10-CM codingCPT-4 codingHCPCS codingCoding complianceData analysisComputerized encoder applicationsMedical terminologyHealthcare degreeDecisive judgmentCommunication skillsOrganizational skillsCritical thinkingMentoring skillsPresentation skillsTeamwork