Medical Coding Specialist

2 weeks ago


San Francisco, California, United States GoHealth Urgent Care Full time
Job Summary

The Provider Coding Educator is a key member of the GoHealth Urgent Care team, responsible for ensuring accurate and compliant medical record coding and documentation. This role involves coordinating medical record coding audits, conducting provider training sessions, and developing training guidelines and procedures to maximize reimbursement.

Key Responsibilities
  • Perform coding audits to ensure procedure codes are accurate based on diagnosis.
  • Review medical record documentation to ensure compliance with billing, risk management, and legal requirements.
  • Maintain accurate records of provider audits and make recommendations for changes in policies and procedures, guidelines, and training programs.
  • Work closely with Corporate Compliance to identify areas of opportunity for medical record coding and documentation improvement.
  • Develop and implement onsite education and training for providers to ensure accurate documentation and medical coding in real-time.
  • Provide consultation to providers to improve medical record documentation and ensure proper coding to maximize claim reimbursement.
  • Develop and implement coding education for new hire providers.
  • Perform data analysis and evaluate denial reports from all payers to identify revenue enhancement opportunities.
  • Participate in committees and meetings related to coding, billing, and documentation.
Requirements
  • High School Diploma or GED
  • Bachelor's Degree preferred
  • 5+ years of outpatient office procedure coding experience
  • 2+ years of training providers on chart documentation and coding guidelines
  • Experience with delivering presentations, conducting one-on-one education with providers, teaching a coding class, or speaking at coding seminars
  • Medical Coding Certificate - RHIT, CPC, or CCS-P
  • ICD10 Proficiency
Additional Knowledge and Skills
  • Federal laws and regulations affecting coding requirements
  • Working knowledge of payor guidelines
  • Knowledge of revenue cycle and billing practices
  • Knowledge of EMR required, eClinical Works and/or Epic preferred
  • Knowledge of PowerPoint, Microsoft Word, and Excel
  • Strong communication and interpersonal skills
  • Organizational skills


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