Medical Coding Educator Specialist

1 week ago


Stamford, Connecticut, United States TAL Healthcare Full time
Job Summary

The Coding and Documentation Expert role provides day-to-day coding and documentation education and support to medical providers and coding staff in concert with organizational goals related to correct coding and documentation. The Coding and Documentation Expert conducts provider coding education along with coding, billing, and documentation audits for accuracy of ICD-10-CM, CPT, HCPCS codes, modifiers, and charges to ensure coding compliance with all regulatory reporting requirements and organizational policies and serves as a resource to staff for coding questions and support.

This position requires collaboration with the Coding Manager, Compliance Team, and other departments to support system-wide external audit programs by providing remedial and ongoing education to providers focused on identified documentation discrepancies. Additionally, this role works closely with the Coding Manager, Compliance Team, and new provider onboarding teams to provide documentation and coding education to physicians and non-physician practitioners during orientation. The expert reviews and audits documentation in Practice's medical record system with new providers prior to billing to ensure accuracy and understanding of coding and documentation concepts. They also perform internal retrospective, concurrent, or prospective medical chart audits to assure that CPT codes billed are appropriate and supported by documentation in the patient record, and that all coding/documentation combinations are compliant with Federal and State regulations. Furthermore, they research third-party payer medical and administrative policy that may affect the practice's clinical and billing operations, develop training materials and presentations for effective provider and staff education, and provide ongoing coding feedback and training to physicians and non-physician practitioners.

The ideal candidate will possess at least three (3) years recent coding experience, including one (1) year coding and documentation auditing experience in a healthcare setting. They must also hold AAPC Certified Professional Coder (CPC) certification and have advanced knowledge of ICD-10, CPT, and HCPCS coding principles, government regulations, protocols, and third-party requirements regarding billing and compliance. Strong organizational skills, effective time management, research, and presentation skills are also essential. This individual will work independently with minimal supervision and collaborate effectively with various stakeholders to achieve organizational goals.

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