Coding Educator - Validator (Remote)

Cape Cod Healthcare Inc.; Hyannis (MA); On-site; USD 90,000 - 110,000; Full time

Job summary

Cape Cod Healthcare, Inc. seeks an experienced Coding Auditor and Educator to lead inpatient and outpatient record audits, ensuring ICD-9/ICD-10 accuracy and compliance.

The role includes educating the coding staff, developing training materials, and aligning practices with AHIMA standards. Responsibilities include conducting educational sessions, reviewing third-party findings, and advising on physician documentation to improve hospital data quality.

Qualifications

• Minimum of 5 years inpatient coding experience in an acute care facility.
• AHIMA CCS credential and AHIMA ICD-10 Trainer certification required.
• Excellent communication skills and ability to educate staff.
• Outpatient coding experience preferred.
• Proficient with Word and Excel; able to develop training materials.

Responsibilities

• Perform inpatient and outpatient medical record audits for accurate diagnoses and procedures per coding guidelines and regulations.
• Provide feedback to Sr. Coding Manager on potential compliance issues.
• Educate coders on validation findings to improve coding knowledge.
• Lead educational sessions on new coding guidelines and billing regulations.
• Develop curriculum and training materials for ICD-9-CM/ICD-10-CM and CPT coding.
• Revise best-practice coding policy recommendations.
• Assess physician documentation and suggest coding strategies to improve data quality.
• Review third-party audit findings and provide educational guidance to coders.
• Offer coding support and answer questions for Patient Financial Services and others.
• Maintain up-to-date knowledge of coding and reimbursement rules; manage modifiers and edits.
• Stay current in coding areas through continuing education units.

Education

AHIMA CCS credential

AHIMA ICD-10 Trainer

AHIMA RHIT or RHIA preferred

Tools

Siemens Soarian

3M coding software

Microsoft Word

Microsoft Excel

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

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