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Work Shift
Day Work Day(s)
Monday-Friday Shift Start Time
8:00 AM Shift End Time
4:30 PM Worker Sub-Type
Regular Children’s is one of the nation’s leading children’s hospitals. No matter the role, every member of our team is an essential part of our mission to make kids better today and healthier tomorrow. We’re committed to putting you first, and that commitment is at the heart of our company culture: People first. Children always. Find your next career opportunity and make a difference doing what you love at Children’s.
Job Description
Oversees the provision of education in coding and billing compliance within Children’s Physician Group to physicians, physician assistants, nurse practitioners, and clinical service auxiliary providers to improve the workflow and promote overall clinical documentation improvement. Develops workplans for the coding education specialists with measurable short term and long-term goals that adhere to internal and external coding and billing policies. Supervises and prioritizes the daily work of the coding education specialists. Creates, reviews, and approves communication of important coding and billing information for administrative and finance leaders as it relates to their areas. Assists team members in the development of evaluation and management and other billing code compliance and utilization reports for comparison to internal and external benchmarks. Supports the improvement of overall coding and billing practices of the physician professional services. Experience
5 years of experience in coding
Strong knowledge base and experience in interpreting and applying federal/government regulations to ensure coding and documentation compliance
Preferred Qualifications
Experience in physician practice coding
Education
Graduate of approved Health Information Technology or Health Information Management program
Certification Summary
Certified Professional Coder (CPC), Certified Professional Coder-Payer (CPC-P), Certified Coding Specialist (CCS), Certified Coding Specialist- Physician-based (CCS-P)
Knowledge, Skills, and Abilities
Strong knowledge base in complete and accurate clinical documentation in all healthcare settings and for all healthcare disciplines
Strong knowledge base of the conventions, rules, and guidelines for multiple classification and reimbursement systems (e.g., ICD -10, diagnosis-related group, and all patient refined diagnosis-related group)
Demonstrated knowledge of medical terminology, anatomy and physiology, pharmacology, computers, and encoding software
Demonstrated strengths in teaching and presentation skills
Must be detail-oriented, possess good problem-solving skills, and have legible handwriting
Must be able to successfully pass the Basic Windows Skill Assessment at 80% or higher rating within 30 days of employment
Job Responsibilities
Assists coding education specialists in providing appropriately messaged and continuous education and updates to physicians, advanced practice providers, and practice leadership regarding coding and billing practices to meet regulatory requirements and capture appropriate revenue.
Develops workplans for the coding education specialists with measurable short term and long-term goals that adhere to internal and external coding and billing policies.
Supervises and prioritizes the daily work of the coding education specialists. This includes monitoring department and individual goals and reprioritizing efforts given urgent Compliance or revenue concerns.
Oversees the education of physicians and key healthcare providers regarding clinical documentation improvement and the need for accurate and complete documentation in the health record.
Responsible for all aspects of managing and leading a team including interviewing, hiring, training, developing, directing work and processes, managing performance, recognizing, and rewarding employees.
Educates and monitors the other coding education specialist trainings as assigned for new physicians and advanced practice providers on coding needs specific to their specialty as part of the onboarding experience. Keeps a log of training completion as required for physician incentive and Compliance.
Performs and helps other education specialists perform shadowing services for billing providers and administrative staff to gather information and provide constructive input to operations and the billing provider to become more efficient in daily workflow and accuracy in charge selection supported by their clinical documentation.
Partners with Coding, Compliance, and other applicable departments on coding issues while coordinating review of open issues and monitoring until resolved.
Monitors coding resources and payer updates for issues that impact professional billing and reports to manager.
Develops tools as assigned that will assist providers, practice management, and office staff to meet regulatory requirements and capture all appropriate revenue.
Analyzes billing and denial information, claim error, and other data for potential coding and billing opportunities.
Summarizes and reports findings to manager and uses findings in educational trainings.
Understands post-billing review findings and assists in relaying constructive education for the purpose of improving deficiencies identified in the review.
Reviews and analyzes evaluation and management coding and other billing trend profiles to identify patterns that may provide clues requiring focus for further analysis, support, and/or education.
Monitors the annual review of encounter forms, coding forms, or billing tool information at least annually and recommends changes to codes and encounter form layout as necessary.
Children’s Healthcare of Atlanta is an equal opportunity employer committed to providing equal employment opportunities to all qualified applicants and employees without regard to race, color, sex, religion, national origin, citizenship, age, veteran status, disability or any other characteristic covered by applicable law.