The Coding Educator ensures the TPR organization meets all governmental and payer coding guidelines by providing continuous education to staff, auditing documentation using specific quality tools, and serving as the primary liaison for coding vendors to prevent claim denials. The role is focused on continuous compliance through education and quality analysis.
Responsibilities
- Monitor billing clearance processes in compliance with TPR policy for new clinicians, advanced practice providers (APRNs, PAs), coders, and ancillary staff performing coding functions.
- Deliver continuous coding education to clinicians and ancillary staff to ensure adherence to all TPR coding policies, payer guidelines, and governmental regulations.
- Identify and mitigate organizational risk by validating that all billed services are accurately coded.
- Proactively research and disseminate updates regarding new coding information, rules, laws, and statutes from all payers and government entities to providers and relevant staff.
- Monitor coding patterns, perform audits, and provide constructive feedback to clinicians and staff members.
- Review and promptly respond to all coding inquiries from clinicians and ancillary staff.
- Analyze coding KPIs and monitor denials to develop and implement strategic prevention plans with defined benchmarks and milestones.
- Act as the primary liaison between the organization and coding vendors, leading all interactions within assigned markets.
- Establish and execute a recovery/remediation plan for identified coding errors, with the approval of the regional coding director.
- Organize and actively participate in all scheduled coding team meetings
Qualifications
Education
Required: High School Diploma or equivalent
Preferred: Post-secondary Anatomy and Physiology
Experience
Required: 2-3 years’ coding, training, or auditing experience in a multi-specialty medical environment.
Knowledge of government regulations for coding and documentation for professional coding
Certifications
Preferred: AHIMA or AAPC coding credentialed, CPC or CCS minimally
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