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Coding Quality Reviewer and EducatorBrown University Health • Providence, Rhode Island, United States
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Coding Quality Reviewer and Educator

Brown University Health
  • US
    Providence, Rhode Island, United States
  • US
    Providence, Rhode Island, United States
Apply Now

About

Summary Under the direction of the Manager of Coding Policy and Education, research coding and documentation guidelines and creates/updates policies as needed. Develops Brown University Health training materials, works with Manager to publish materials online and updates materials as needed. Performs audits on schedule or as assigned based on department policy, coding guidelines, payer rules, and/or system policies. Identifies external resources, assists with external audits, records results and schedules related feedback sessions. Works with the manager to provide regularly scheduled education. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done.
Instill Trust and Value Differences
Patient and Community Focus
Collaborate
Responsibilities Consistently apply the corporate values of respect, honesty and fairness with the constant pursuit of excellence in improving the health status of the people of the region through the provision of customer-friendly, geographically accessible and high-value services within the environment of a comprehensive integrated academic health system. Assume responsibility for knowing and acting in accordance with the principles of the Brown University Health Corporate Compliance Program and Code of Conduct.
Research coding and documentation guidelines from reliable sources, collect relevant information and compile that information into a user-friendly manual. Record various training materials for coders and providers and work with Manager to publish recorded materials on the Brown University Health Intranet. Prepare for and conduct education sessions which include specialty specific coding and documentation guidelines, examples of relevant medical records, resource materials, etc. Work with Manager to review findings from external audits and coordinate related feedback sessions with coders, validators and providers. Track internal and external audits and record on detailed log. Adhere to audit schedule. Perform analysis of reports on key coding and auditing metrics. Identify trends and report those trends to the Manager. Assist Manager with ROI analyses. Stay abreast of all coding updates, including new/deleted ICD-10 codes, new/ deleted CPT codes, new/ deleted HCPCS codes and any coding guideline changes. Review payer updates and notify Manager of any pertinent changes impacting coding/documentation. Create all components of a successful education process, including lesson planning and materials used for educational purposes (i.e. audiovisual aids, Epic Tips sheets, knowledge retention exams, etc.). Assist with educating validators/coders as requested. Abide by the Standards of Ethical Coding as set forth by the American Health Information Management Association and the American Association of Professional Coders. Monitor validators for violations and report to PFS Manager or Director when areas of concern are identified. Maintain confidentiality of sensitive information at all times. Participate in various committees, task forces and quality improvement teams as needed. Perform other duties as necessary.
Minimum Qualifications BASIC KNOWLEDGE: Associate degree or 3 years of experience in a medical coding/validating role.
Certification required: CCS, CPC, RHIA or RHIT considered. Specialty certification a plus or willingness to obtain specialty certification.
Excellent verbal and written communication skills with technical proficiencies to include Microsoft Excel & PowerPoint, and Teams applications.
Experience: Three to five years progressively responsible experience performing outpatient coding. Experience in a large, multispecialty physician group and/or complex academic medical center preferred. Experience should demonstrate a high level of knowledge in ICD-10-CM and CPT-4 coding methodologies. Experience with Epic preferred.
Independent Action Performs independently within the department's policies and procedures. Refers specific complex problems to the Manager when clarification of the departmental policies and procedures are required. Must be able to work with minimal supervision.
Work Environment and Physical Requirements Remote work from home.
Supervisor Responsibility None
Pay Range $66,397.24-$109,529.06
EEO Statement Brown University Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, ethnicity, sexual orientation, ancestry, genetics, gender identity or expression, disability, protected veteran, or marital status. Brown University Health is a VEVRAA Federal Contractor.
Location Corporate Headquarters - 167 Point Street Providence, Rhode Island 02903
Work Type M-F DAYS
Work Shift Day
Daily Hours 8 hours
Driving Required No
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  • Providence, Rhode Island, United States

Languages

  • English
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