Education Specialist, Provider Coding

WakeMed; Raleigh (NC); On-site; USD 70,000 - 90,000; Full time

Job summary

WakeMed in Raleigh, North Carolina is seeking a Subject Matter Expert in coding education to support coding staff and providers. This role will involve developing educational resources and conducting audits to optimize documentation and compliance.

The ideal candidate will have at least 5 years of experience in coding or auditing, along with required certifications like Certified Professional Coder. You will be expected to stay updated on coding practices and provide timely guidance.

Qualifications

• 5 years of experience in coding or auditing is required.
• Certifications in professional coding are mandatory.
• Familiarity with CMS documentation guidelines is essential.

Responsibilities

• Guide coding education for providers and staff.
• Support education efforts related to insurance denials.
• Conduct audits and prioritize education for stakeholders.

Skills

Coding education

Data analysis

CMS guidelines

Education

High School Diploma or Equivalent

Certified Professional Coder or Certified Coding Specialist - Physician or Registered Health Information Technician

Job description

Overview

"Serves as the subject matter expert and resource for provider coding education, coding staff education, coding related questions, and insurance denials. Responsible for developing a work-plan to conduct financial and other specified audits so that appropriate education can be developed, prioritized, and delivered to providers and coders. Analyzes and trends data to identify areas of opportunity related to documentation and coding. Educates providers regarding correct documentation per CMS guidelines to ensure the organization is billing appropriately. Stays current on coding updates and communicates changes to providers and coders in a timely manner."

Responsibilities

• Provide subject matter expert guidance for provider coding education and coding staff education.
• Answer coding-related questions and support education efforts related to insurance denials.
• Develop work-plans to conduct financial and other specified audits and deliver prioritized education to providers and coders.
• Analyze data and trends to identify opportunities related to documentation and coding.
• Educate providers on correct documentation per CMS guidelines to ensure appropriate billing.
• Stay current on coding updates and communicate changes to providers and coders in a timely manner.

Licensure

• Certified Professional Coder Or Certified Coding Specialist- Physician Or Registered Health Information Technician Required

Education

• High School Diploma or Equivalent Required

Experience

• 5 Years Coding - Physician Or Auditing Required

EOE