Senior Medical Coding Educator and Data Consultant

The Ohio State University Wexner Medical Center; Rockford (IL); Remote; USD 75,000 - 110,000; Full time

Job summary

A leading healthcare organization is seeking a Senior Coding Education and Data Consultant to promote coding compliance within federal and state regulations. The role involves extensive analysis, engaging with various stakeholders, and implementing educational plans to enhance documentation and coding practices.

Qualifications

• Minimum 6 years relevant experience in coding or CDI.
• Expertise in ICD-10-CM/PCS and CPT-4 coding.
• Strong understanding of complex disease processes.

Responsibilities

• Ensure coding compliance and conduct data analysis.
• Evaluate medical record documentation quality.
• Guide root cause analysis and present findings.

Skills

Leadership

Communication

Clinical Knowledge

Data Analysis

Education

Bachelor's degree in Health Information Management

RN license (alternative qualification)

Tools

3M encoder

Job description

Health System Shared Services | MIM CDI and Coding

Scope of Position :

• Ensures documentation and coding compliance, is responsible for conducting data analysis, generating and developing reports, auditing coding and medical record documentation, identifying improvement opportunities, and creating education plans for coders, CDIs, and providers. This role is expected to develop an action plan and influence adoption by effectively engaging coding, CDI, and providers.
• Evaluates performance to assess the quality of medical record documentation and coding, preparing recommendations based on the results
• Monitors the case-mix index for services and hospital entities, Vizient and hospital-related quality initiatives (e.g., patient safety indicators, pressure ulcer monitoring, mortality reviews, etc.), and the Program for Evaluating Payment Patterns Electronic Report (PEPPER). These measures help identify opportunities for improvement and help ensure compliant coding.
• Provides and presents detailed findings reports and will conduct in-depth reviews of billed codes, charges, and modifiers and report findings
• Serves as a subject matter expert on compliant documentation and coding opportunities
• Will guide root cause analysis, measure coding and reimbursement opportunities and risks, and then communicate these findings to the Director of Coding and Compliance, as requested by the Administration.

Position Summary

• Conduct health-system-wide coding analyses to promote compliance with federal and state regulations pertaining to but not limited to ICD-10-CM, ICD-10-PCS, and CPT-4 coding, assignment of modifiers, charge entry, and data abstraction for hospital billing and must understand the principles of physician documentation
• Under the direction of the Director of Inpatient Coding and Compliance, the Senior Coding Education and Data Consultant assists in determining controls and monitors risk areas or changes to review risk management and ensure compliance with documentation and coding regulations
• Operate with extreme tact and diplomacy in performing job duties while interacting with faculty and staff from all areas of the Medical Center

Required Qualifications

• Bachelor's degree in Health Information Management or equivalent experience with extensive clinical knowledge and a minimum of 6 years of relevant experience is required
• One of the following certifications is required : Accredited as a Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Documentation Improvement Professional (CDIP) by the American Health Information Management Association, or Certified Clinical Documentation Specialist (CCDS) by ACDIS
• Candidates with a Bachelor's degree in Nursing will be considered in lieu of a Bachelor's degree in Health Information Management and have a current RN license. A minimum of 6 years of relevant experience (with two (2) years of inpatient-based coding / CDI) is required. 8-12 years of relevant experience preferred.
• Candidate should possess a broad knowledge of complex disease processes, preferably in an inpatient setting
• Knowledge of ICD-10-CM, ICD-10- PCS, Official Coding Guidelines, and Medicare Billing Rules is required
• Must possess strong leadership skills, such as the ability to guide and motivate a team, and effective communication skills, including the ability to convey complex medical information to CDI, coding, and clinicians
• Should demonstrate competency in the teaching / learning process, organizational skills, and computer literacy

Preferred Qualifications :

• Experience as an educator
• Experience with 3M encoder and reporting
• Experience utilizing spreadsheets to gather, analyze, and report data
• Knowledge of hospital reimbursement models, trends, and their impact
• Knowledge of medical terminology and anatomy

Additional Information :

Location :

Remote

Position Type : Regular

Scheduled Hours : Shift :

First Shift

Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process.

The university is an equal opportunity employer, including veterans and disability.

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