Senior Professional Coding and Documentation Improvement Specialist - FT - Day -

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Pay Range:

Scheduled Weekly Hours:

Position Overview

Responsible for leading complex coding reviews, optimizing provider documentation, and improving coding accuracy and compliance. Provides assistance and support to manager as it relates to time management, delegation of workflow tasks and responsibilities, knowledge of industry guidelines, laws and regulations. Assists in analysis and reporting of record review findings in order to monitor trends and outcomes. Responsible for coordinating physician education sessions, correspondence with physicians, and maintenance of Capital Health Medical Group (CHMG) educational website. Responsible for coordination and provision of large group education sessions for all CHMG providers.

MINIMUM REQUIREMENTS

Education: High School Diploma or equivalent. Associate's degree in health information management preferred. Certified Professional Coder (CPC) or Certified Coding Specialist-Physician-based (CCS-P) required. Physician coding and Training certification.
Experience: Three years’ experience in professional coding role with monitoring and education experience required. ICD-10-CM, CPT, CM, and HCPCS coding experience.
Other Credentials:
Knowledge and Skills: Excellent verbal and written communication skills. Knowledge of pathophysiology and disease processes. Strong knowledge of industry guidelines and laws for physician coding and reimbursement. Possesses research and analysis skills.
Special Training: Proficient with Microsoft applications to include Outlook, Word, Excel, PowerPoint. Medical Terminology, Anatomy and Physiology, or Pathophysiology knowledge. Ability to develop, implement and deliver, and assess coding education plans using a variety of methods to individual providers or provider groups.
Mental, Behavioral and Emotional Abilities: Ability to work in environment using multiple EMR systems. Ability to learn and develop auditing and education skills to perform physician education. Ability to work collaboratively with others as well as independently.
Usual Work Day: 8 Hours
Reporting Relationships
Does this position formally supervise employees? No

If set to YES, then this position has the authority (delegated) to hire, terminate, discipline, promote or effectively recommend such to manager.

ESSENTIAL FUNCTIONS

Assists manager with ongoing monitoring and education process by assuming responsibility for coordination and scheduling, as well as research, design and delivery of large group education sessions to ensure accurate and compliant physician documentation and coding.
Researches and provides up-to-date information to departmental staff to promote compliance with industry and government regulations. Research coding and reimbursement issues and reports findings to manager, physicians, and staff.
Develops and coordinates education and training programs on coding and documentation for department staff, physicians, and ancillary departments.
Performs analysis and trending of record review results to achieve optimal coding accuracy and compliance of CHMG providers.
Develops and disseminates customized education programs to educate CHMG providers regarding documentation requirements needed for accurate code assignments.
Monitors provider selected E&M codes on a routine and focused basis to ensure documentation supports medical necessity, code specificity, and compliance to promote the highest coding accuracy.
Support external audit responses and mitigation efforts.
Meets or exceeds departmental accuracy and productivity standards. Fosters teamwork and collaboration.
Proactively troubleshoots documentation or communication problems and appropriately escalates to senior level.
Maintains a level of expertise by attending continuing education programs.
Adapts to changing department demands required for higher department efficiency.
Assists manager in the training of new employees in an effort to maintain a productive workforce and environment.

Performs all other duties as assigned.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

Frequent physical demands include:

Occasional physical demands include: Standing , Walking , Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Wrist position deviation , Pinching/fine motor activities , Keyboard use/repetitive motion , Taste or Smell , Talk or Hear

Continuous physical demands include: Sitting

Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs.

Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Minimal Color Discrimination, Accurate Depth Perception, Accurate Hearing
Anticipated Occupational Exposure Risks Include the following: N/A

This position is eligible for the following benefits:

• Medical Plan

• Prescription drug coverage & In-House Employee Pharmacy

• Dental Plan

• Vision Plan

• Flexible Spending Account (FSA)

- Healthcare FSA

- Dependent Care FSA

• Retirement Savings and Investment Plan

• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance

• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance

• Disability Benefits – Long Term Disability (LTD)

• Disability Benefits – Short Term Disability (STD)

• Employee Assistance Program

• Commuter Transit

• Commuter Parking

• Supplemental Life Insurance

- Voluntary Life Spouse

- Voluntary Life Employee

- Voluntary Life Child

• Voluntary Legal Services

• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance

• Voluntary Identity Theft Insurance

• Voluntary Pet Insurance

• Paid Time-Off Program

The pay range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity. Bonus and/or incentive eligibility are determined by role and level.

The salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, differential pay or other forms of compensation, compensation allowance, or benefits health or welfare. Actual total compensation may vary based on factors such as experience, skills, qualifications, and other relevant criteria.