Coding Consultant Job Description
Coding consultant
provides feedback to the coding management team and staff regarding highly complex ICD-9-CM/CPT-4 or ICD 10 CM/PCS coding and DRG/APC assignment and related clinical documentation.
Coding Consultant Duties & Responsibilities
To write an effective coding consultant job description, begin by listing detailed duties, responsibilities and expectations. We have included coding consultant job description templates that you can modify and use.
Sample responsibilities for this position include:
Provide ICD10 HCC coding training to providers
Demonstrate and share knowledge of medical terminology, International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) coding
Communicates and educates clients on coding and billing compliance, regulatory updates specific documentation requirements
Audit CPT, ICD-9/ICD-10 and HCPCs codes
Compile reports for clients based on audit findings
Plan and manage registration, patient insurance, billing and collections to ensure an efficient collections process
Present educational sessions and audit findings to small and large groups
Assist clients with litigation issues
Works on multiple IT platforms, including patient finance, encoders, Precyse and client IT systems
Work with corporate operations to develop program success metrics and ongoing performance metrics Provide strong leadership and judgment
Coding Consultant Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Coding Consultant
List any licenses or certifications required by the position: CPC, CCS, CPT, COC, ICD, CRC, CCA, RHIT, CM, ICD10
Education for Coding Consultant
Typically a job would require a certain level of education.
Employers hiring for the coding consultant job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Nursing Program, Nursing, Healthcare, Education, Health, Health Information Management, Information Security, Health Care, Business, Business/Administration
Skills for Coding Consultant
Desired skills for coding consultant include:
EMR for recording patient visits
ICD10
Billing/claims submission and other related actions
ICD10-CM coding
Anatomy and physiology
CMS-HCC model and guidelines along with ICD-9/10 and guidelines
Excel
Medical terminology
Coding and application
Desired experience for coding consultant includes:
Utilizing data analysis, identify and target providers who would benefit from Medicare Risk Adjustment training and documentation/coding resources
Facilitate the creation and implementation of measurable improvement strategies in the areas of physician clinical documentation, medical record coding, and submission of data
Assist providers as related to CMS-HCC Risk Adjustment payment methodology, proper chart documentation, and diagnosis coding to revenue
Provide measurable, actionable solutions to provider that will result in improved accuracy for documentation and coding practices
Work collaboratively with the CPC Team in development of disease specific training education and tools
Complete provider visits performing duties described above
Coding Consultant Examples
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Coding Consultant Job Description
Job Description Example
Our company is growing rapidly and is looking to fill the role of coding consultant. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for coding consultant
- Ensure member encounter data is being accurately coded and all diagnosis codes are captured
- Train Providers on our Risk Adjustment tools, and work toward the adoption of these programs into their practices
- Collaborate with doctors, coders, facility staff and a variety of internal and external personnel on a wide scope of Risk Adjustment and Quality education efforts
- Reach out to physicians, medical groups, IPAs and hospitals, to build positive, long-term, consultative relationships
- Participate in the development of strategic coding and HIM communication and education plans which outline the target audience, training needs, training methods, implementation, and evaluation for PSG
- Participate in the development of coding and HIM content-specific, competency-based, and operational-based communication and education deliverables in conjunction with specific business unit resources and technical experts from the field
- Participate in the delivery of communication and coding and HIM training to various groups, including leadership teams and end-users
- Inform the Director of Education and the AVP of any significant issues (e.g., education process issues, payer issues, vendor issues)
- Inform the Director of Education and the AVP and cross functional teams regarding unique coding and HIM documentation payer requirements, significant changes and developments
- Assist the Director in the maintenance of coding and HIM training administration records
Qualifications for coding consultant
- Analyze training course evaluations, and recommend appropriate action to incorporate feedback
- Provide coding/HIM education to Central Coding Support staff to assure quality of work
- Identify and implement process improvements to lower costs and improve service to customers
- Champion ideas for innovation, knowledge sharing and coding operations workflow in the PSG organization and among peer groups
- Stay abreast of coding/billing regulatory requirements and company compliance policies, ensuring timely staff education
- Understand and communicate nuances of unique coding requirements for major payers such as Medicare, Medicaid, HMO’s, PPO’s, IPA’s, employers
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Coding Consultant Job Description
Job Description Example
Our growing company is hiring for a coding consultant. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for coding consultant
- Provide subject matter expertise in the development, implementation and monitoring of coding related standard master files, processes, and reporting
- Demonstrate and apply knowledge of principles and practices of Education and Organizational Development
- Assist in translating business reporting requirements to development staff
- Understand Revenue Cycle operations and technologies currently in place
- Presents on the Prsecyse HIM Consulting call once per year on a relevant Industry or client topic
- Complete over-reads or reover-reads for maintenance and/or Preceptee weekly assignments and report to Quality Managers weekly or as needed
- Review and approve timecards and time off requests, ensuring you have adequate staffing at all times to meet company needs
- Develop and submit improvement plans for team members who perform below departmental standards relating to attendance, accuracy and productivity
- Maintain Outlook Calendar arranging interviews, team meetings, Quality Manager meetings and Director meetings as needed
- Prepare Staffing Report and Weekly Team Report with other leads on your team to be submitted weekly to your Quality Manager following department policy
Qualifications for coding consultant
- Maintain ongoing verbal and email communication with in-house and remote team members, Quality Managers and other departments to ensure the efficiency of your team
- Attend meetings and trainings as required by the Quality Department
- 3-5 years’ work experience, preferably with medical record review and chart abstraction
- Assists providers in understanding the Medicare quality program CMS-HCC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation of procedures and diagnosis coding
- Must be able to work effectively with common office software, coding software, EMR and abstracting systems
- Certified Professional Coder / CPC-A or willingness to obtain required certification within first year in position
3
Coding Consultant Job Description
Job Description Example
Our company is searching for experienced candidates for the position of coding consultant. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for coding consultant
- Conducts chart reviews based on all appropriate coding rules, regulations, and guidelines
- Ensures compliance with coding policies and procedures
- Monitors and trends payment denials and rejections to determine coding problems
- Ensures physician and practice staff receives proper education on CPT, HCPCS, and ICD-9-CM coding regulations including new provider orientation
- Due diligence and post acquisition support for new providers including data trending and documentation review as appropriate
- Initiates, develops and presents physician and staff training programs for better understanding of the coding and billing process
- Follow up results of Regulatory Compliance Support reviews to ensure corrective action implemented for appropriate coding
- Assist the Division Coding Manager on coding projects related to appropriate coding and billing
- Attend sales calls and demo meetings to support the business development process
- Create and deliver technical POC’s (Proof of concept) both onsite and offsite
Qualifications for coding consultant
- Provide demonstrations and trainings, online or in-person, for our customers
- Be the go-to person for any customer’s technical related questions in sales meetings
- Attend relevant worldwide conferences
- Become an expert on Justinmind’ products and conduct use case discussions with qualified leads and customers
- A person with the highest level of integrity
- A self-starter able to work independently and within a team, good teamwork skills
4
Coding Consultant Job Description
Job Description Example
Our innovative and growing company is looking for a coding consultant. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for coding consultant
- Proficient use of analytical tools and is able to develop logical approaches to analysis
- Implements and oversee quality of deliverables and effectively manages day-to-day relationships to ensure high performance service
- Applies specialized knowledge and skills to address client issues and shares knowledge with others
- Participates in the development of presentations of proposals for business development
- Clearly and concisely conveys more complex messages to the team and to the client
- Draft sound and well structured recommendations with little guidance to include the ability to design deliverables to fit the engagement contract and the client's needs
- Set priorities and organize tasks that will manage pieces of project/engagements to include facilitating internal meetings
- Ability to deliver project reviews
- Perform CPT coding / DRG validations and provide outcomes management for decreasing denied claims
- Required to complete 12 - 15 DRG validations /or 6-8 coding audits per week and provide educational letters on those reviews back to providers
Qualifications for coding consultant
- Project and personnel management experience preferred
- RN/LPN or Certified Medical Coder
- Medical benefits coding experience required
- Ability to travel as required for the role, most cases to the East Coast
- Ability to identify, design and implement creative business and technology solutions
- Minimum 2 or more years consulting experience or 4 or more years relevant industry experience preferred
5
Coding Consultant Job Description
Job Description Example
Our company is hiring for a coding consultant. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for coding consultant
- Partner with the Healthcare Advocates in the field to implement prospective programs as directed by Market Consultation leadership
- Provides subject matter guidance in development of new training materials and collateral for internal and external use
- The certified coder reviews, analyzes, and codes diagnostic information in a patient’s medical record based on client specific guidelines for the project
- Coders must meet and maintain 95% coding accuracy rate
- Any other task requested by management
- Partners with Healthcare Advocates in the field and will be assigned providers to embed based on data analysis where they need support / training on improving documentation and coding accuracy
- Assists providers in understanding the Medicare quality (HEDIS / STARS) program CMS-HCC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation of procedures and diagnosis coding
- Gathers business requirements and interpret them
- Leads lower level Analysts
- Ability to solve complex problems and develop innovative approaches
Qualifications for coding consultant
- Industry related certifications (PHR, CPP, FPC, ) are a plus
- Work experience or certifications in networking, database usage, SQL, SQR,or data science/coding desired but not required
- Previous programming/coding skills are a plus-Experience providing integration services to external clients desired
- Able to work out of the Maitland, FL office
- Thorough knowledge of applicable regulatory rules and guidelines
- Registered Nurse with 10+ years of experience