Professional Fee Coding Educator

Community Health Systems; United States; On-site; USD 65,000 - 90,000; Full time

Job summary

The Physician Education Specialist at Community Health Systems provides training to CHS-affiliated providers and staff on accurate coding and documentation to ensure compliance with federal, state, and local laws. This role includes conducting educational sessions, performing compliance reviews, and creating materials to promote adherence to regulatory standards and organizational policies.

Responsibilities also include identifying educational needs, updating resources, and staying current on

Qualifications

• In-depth knowledge of coding and documentation guidelines including CPT, ICD-10-CM, and HCPCS.
• Ability to train providers and staff on documentation improvements.
• Experience with compliance and regulatory changes in healthcare.

Responsibilities

• Conduct training sessions and educational meetings for CHS-affiliated providers and staff.
• Review medical records for accurate coding and documentation in line with payer requirements.
• Identify educational needs and provide guidance on documentation and coding improvements.
• Develop, update, and maintain educational materials for coding and documentation.
• Stay current on regulatory changes and update staff accordingly.
• Collaborate with clinicians, coders, and staff to address documentation issues.
• Prepare reports of compliance reviews and present findings to management.

Skills

Coding knowledge

Presentation skills

Communication skills

Documentation materials development

Organization & time management

Travel willingness

Education

Bachelor's degree (Healthcare Admin)

H.S. Diploma or GED

Tools

Coding systems knowledge (CPT, ICD-10-CM, HCPCS)

Job description

Job Summary

The Physician Education Specialist provides training and education to CHS-affiliated providers and staff on accurate coding and documentation to ensure compliance with federal, state, and local laws. This role involves conducting educational sessions, performing compliance reviews, and creating educational materials to promote adherence to regulatory standards and organizational policies.

Essential Functions

• Conducts training sessions, seminars, and educational meetings for CHS-affiliated providers and staff, including the PPS Physician Coding and Documentation Seminar.
• Reviews medical records to ensure accurate coding and documentation of evaluation and management services, procedures, and other physician work in compliance with Medicare, Medicaid, and other payer requirements.
• Identifies and communicates educational needs to providers and coding staff, offering guidance on documentation and coding improvements.
• Assists in developing, updating, and maintaining educational materials and resources to support compliance with coding and documentation regulations.
• Remains current on legislative and regulatory changes impacting coding, documentation, and compliance, and updates staff and providers accordingly.
• Collaborates with CHS-employed clinicians, coders, and ancillary staff to address documentation and coding issues, ensuring best practices and compliance.
• Prepares comprehensive reports of compliance reviews, including recommendations for improvement, and presents findings to management, providers, and coding teams.
• Maintains strict confidentiality regarding provider information, patient data, and financial records, ensuring compliance with organizational policies.
• Reports noncompliance issues identified through audits and reviews to the department manager, director, or senior director.
• Coordinates travel arrangements as necessary to fulfill job responsibilities, adhering to organizational travel policies.
• Performs other duties as assigned.
• Maintains regular and reliable attendance.
• Complies with all policies and standards.

Qualifications

• H.S. Diploma or GED required
• Bachelor's Degree in Healthcare Administration, Business Administration, or a related field preferred
• 2-4 years of experience in medical coding, documentation, or healthcare compliance required
• 4-6 years of experience in a physician office/clinic working with evaluation management, diagnostic and procedures coding, and/or medical billing preferred

Knowledge, Skills and Abilities

• In-depth knowledge of coding and documentation guidelines, including CPT, ICD-10-CM, and HCPCS coding systems.
• Familiarity with Medicare, Medicaid, and payer-specific regulations and requirements.
• Strong presentation and communication skills to effectively educate providers and staff.
• Ability to analyze medical records and identify compliance risks and improvement opportunities.
• Proficiency in developing and maintaining educational materials for coding and documentation.
• Excellent organizational and time-management skills to handle multiple projects and deadlines.
• Ability to travel as required for training and educational sessions.

Licenses and Certifications

• Certified Coder-AHIMA or AAPC or equivalent preferred
• CCS-Certified Coding Specialist preferred