The Coding Education Specialist (CES) is responsible for reviewing chart notes for accurate code assignment with an emphasis on provider education, documentation and coding improvement, and revenue capture. The CES provides education to clinicians, clinic staff, and others as needed via face-to-face meetings, Teams, WebEx and classroom settings. The CES also develops, maintains and presents coding and compliance educational materials to staff and clinicians. In addition, the CES collaborates with the Manager of Physician Coding Education to support the needs of PBS where coding expertise/education is needed. This position is also responsible for analysis and assessment of governmental and non-governmental payer audits, conducts focused reviews and monitors provider compliance with medical record documentation after training and education.
Job Duties and Responsibilities:
Acts as documentation and coding liaison to clinicians to include review, education and vital follow-up to help ensure that clinical documentation and coding services meet government and organizational policies and procedures.
Analyzes and provides education on revenue capture, clinical documentation including Electronic Health Record (EHR) requirements, coding accuracy and denial management to clinicians and clinic staff.
Assists in determining educational needs based on documentation reviews, provider/staff feedback, data analysis (bell curves).
Train new providers and prepare educational materials based on practice questionnaire completed by provider.
Reviews documentation and coding for new providers for accuracy and charge capture as per standard.
Responsible for sending coding reports to providers acquired from coding vendor resources.
Communicates directly with providers on coding feedback and chart review findings.
Prepares vital reports and communicates results of audits to management, clinicians, and committees as appropriate.
Prepare and customize PowerPoint presentation as needed based on requests and needs.
Uses spreadsheets to log physician performance results and to re-educate on those outstanding issues and trends and reports areas of risk directly to the Manager - Physician Coding Education.
Maintains a high standard of proficiency related to clinical documentation and coding in assigned specialty and other areas and compliance with government regulations by going to appropriate workshops and seminars.
Look after Medicare and other Payer rules for updates and changes and supports CSMN's core values, policies, and procedures.
Maintains familiarity with such issues as HCFA E/M Documentation Guidelines, HCFA Teaching Physician Documentation Guidelines and the OIG model compliance plans.
Takes part in seminars and workshops, as applicable, for updates on new coding rules and regulations.
Understands coding trends by billing area, location, and provider for all groups and physicians and
handles in a professional and confidential manner all correspondence, documentation, and files.
High school diploma or GED required. Bachelor's degree preferred.
Certified Professional Coder (CPC) required.
Three (3) years of experience in Coding in advanced professional multi-specialty specific CPT, ICD-10 codes required.
Two (2) years of experience in chart audits/reviews/education and training required.
Working Title: Coding Education Specialist - PBS Compliance
Providing healthcare for more than 100 years, Cedars-Sinai has evolved into one of the most dynamic and highly renowned medical centers in the world. Along with caring for patients, Cedars-Sinai is a hub for biomedical research and a training center for future physicians and other healthcare professionals. This attracts exceptional talent to Cedars-Sinai, including world-renowned physician-scientists who seek a place where they can both conduct research and see patients--the ideal formula for discovery and its translation into cures. Our patients benefit from access to doctors at the top of their fields, and our researchers have an ideal community in which to study the impact of healthcare challenges, and reflect that knowledge in their research. The greater Los Angeles area in which Cedars-Sinai resides possesses unparalleled cultural and ethnic diversity which offers outstanding opportunities for translational and clinical research and a dynamic environment for medical education.Although community based, Cedars-Sinai is a major t...eaching hospital affiliated with the David Geffen School of Medicine at the University of California, Los Angeles (UCLA). Cedars-Sinai has highly competitive graduate medical education programs in more than 50 specialty and subspecialty areas, a graduate program in biomedical sciences and translational medicine, a clinical scholars program directed towards junior physicians with aspirations to become clinical scientists, and post graduate training opportunities.There are more than 250 full-time faculty members at Cedars-Sinai. The voluntary medical staff, comprised of more than 2,200 specialty board-certified or board-qualified physicians, represent all of the specialties and subspecialties and collaborate with full-time medical staff in the teaching responsibilities of the graduate medical education programs.