Coding Educator - Validator (Remote)

Cape Cod Healthcare; Hyannis (MA); On-site; USD 85,000 - 110,000; Full time

Job summary

Cape Cod Healthcare in Hyannis, MA seeks an experienced ICD-9/ICD-10 coder with educator responsibilities to audit inpatient and outpatient records and train coding staff. The role emphasizes accuracy, compliance with AHIMA standards, and ongoing education for CDS and physicians.

Responsibilities include developing training materials, reviewing third-party audits, answering coding questions for Patient Financial Services, and staying current with reimbursement rules.

Qualifications

• Minimum of 5 years inpatient coding experience in an acute care facility.
• AHIMA CCS credential and AHIMA approved ICD-10 Trainer required.
• AHIMA RHIT or RHIA preferred.
• Experience performing outpatient coding preferred.
• Must possess excellent communication skills.
• Siemens Soarian and 3M experience preferred.
• Working knowledge of Microsoft Word and Microsoft Excel required.

Responsibilities

• Audit inpatient and outpatient medical records to validate diagnoses and procedures.
• Provide guidance and education to coders on validation findings.
• Develop curriculum and training materials for staff learning ICD-9-CM / ICD-10-CM and CPT coding.
• Revise and provide recommendations of best practice standards for coding policies and procedures.
• Assess physician documentation and provide recommendations for coding strategies and physician queries.
• Assist in review and assessment of audit findings from third parties and educate coders when required.
• Provide coding support and answer coding questions for Patient Financial Services and other departments.
• Maintain up-to-date working knowledge of all coding and reimbursement rules and regulations.

Skills

Inpatient coding

Auditing

Educator/Training

Communication skills

Education

AHIMA CCS credential

AHIMA ICD-10 Trainer

RHIT or RHIA preferred

Tools

Microsoft Word

Microsoft Excel

Siemens Soarian

3M Coding

Job description

Purpose of Position:

Responsible for performing quality reviews of inpatient and outpatient medical records to validate the integrity of ICD-9/ICD-10 diagnoses and procedures. Also act as an Educator for the Coding staff.

Description

• Perform inpatient and outpatient medical record audits to validate appropriate diagnoses and procedures based on coding guidelines and insurance regulations.
• Abide by AHIMA standards of Ethical Coding when performing validation reviews and provide feedback to Sr. Coding Manager of any potential compliance issues related to coding and physician documentation.
• Provide guidance and education to Coders on validation findings to support compliant coding and increase knowledge and skills.
• Conduct regular educational sessions with Coders (and other hospital staff as needed) on newly published coding guidelines or billing regulations to assure coding staff possess accurate information and follow new requirements.
• Develop curriculum and training materials for staff learning ICD-9-CM / ICD-10-CM and CPT coding.
• Revise and provide recommendations of best practice standards for coding policies and procedures.
• Assess physician documentation and provide recommendations for coding strategies and physician queries that aim to improve hospital severity and mortality data. Will also provide regular education to Clinical Documentation Specialists (CDS) as needed.
• Assist in review and assessment of audit findings from third parties that provide coding validation audits. Formulate and write appeals when appropriate and/or educate Coder(s) when required.
• Provide coding support and answer coding questions for Patient Financial Services and other departments.
• Maintain up-to-date working knowledge of all coding and reimbursement rules and regulations. Must be able to assign modifiers correctly and assist in working edits when necessary.
• Must stay current in all areas of coding and maintain continuing education units to remain credentialed.

Qualifications

• Minimum of 5 years inpatient coding experience in an acute care facility required.
• AHIMA CCS credential and AHIMA approved ICD-10 Trainer required.
• AHIMA RHIT or RHIA preferred.
• Experience performing outpatient coding preferred.
• Must possess excellent communication skills.
• Siemens Soarian and 3M experience preferred.
• Working knowledge of Microsoft Word and Microsoft Excel required.

Schedule Details:

Full-Time, Monday-Friday, Occasional Evenings, Weekends, & Holidays

Organization :

Cape Cod Healthcare, Inc.

Primary Location :

Massachusetts-Hyannis

Department :

HCI-HB Health Info Mgmt

Annual/Hourly:

Unassigned

Hiring Pay Range:

0 - 0