Coding Educator Resume Samples
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Coding Educator Resume Samples
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MZ
M Zemlak
Maximo
Zemlak
59860 Mayer Stravenue
Dallas
TX
+1 (555) 263 9214
59860 Mayer Stravenue
Dallas
TX
Phone
p
+1 (555) 263 9214
Experience
Experience
Chicago, IL
Coding Educator
Chicago, IL
McClure, Huel and Koch
Chicago, IL
Coding Educator
- Coordinates development of documentation improvement educational materials for physicians and other providers
- Assist Regional Coding Educator to develop market specific coding education for providers and coders resulting from results of pre-bill clearance reviews
- Assist the business with research and documentation of workflows, policies and programs and other materials
- Perform face to face presentations at provider facilities
- Develop curriculum and training handbook and create presentations
- Perform quality assurance reviews to assess comprehension of training efforts and assure coding quality
- Conduct training sessions on provider-based coding and billing guidelines
Los Angeles, CA
Medical Coding Educator
Los Angeles, CA
Bednar and Sons
Los Angeles, CA
Medical Coding Educator
- Knowledge of ICD-10 Coding practices
- Assists in the development and performance of physician education sessions related to compliance and coding issues
- Strong technical knowledge of all Microsoft Office applications, including Word, Excel, Access and PowerPoint
- Focusing on potential documentation improvement opportunities and issues by specialty for E&M and surgical clinicians
- Train new providers and faculty staff on E&M coding of their professional services
- Review remittance advises for rejection resolution and training opportunities
- Researches coding and compliance issues related to Practices' new service development (e.g., intensivists, acupuncture, social workers, etc.)
present
Phoenix, AZ
Traveling Senior Coding Educator
Phoenix, AZ
King and Sons
present
Phoenix, AZ
Traveling Senior Coding Educator
present
- Identify coding and documentation trends to develop and comprehensive Provider specific plan
- Report to/works with the Manager of Clinical Quality & Coding
- Educate providers on how to improve their coding and documentation for Risk Adjustment
- Work independently and rely on professional discretion and judgment; as well as a professional representation of Client/Optum
- Provide feedback and present solutions, to the Manager of Clinical Quality & Coding and team members (as warranted), regarding trends or patterns in Provider coding, documentation, HEDIS and /or Stars
- Use independent judgment and decision making to field any Provider questions or concerns
- Conduct medical record review for assessment of coding documentation and HEDIS/Stars measures for accuracy based on the Risk Adjustment Model and ICD-10-CM coding guidelines
Education
Education
Bachelor’s Degree in Competence
Bachelor’s Degree in Competence
University of Central Florida
Bachelor’s Degree in Competence
Skills
Skills
- Strong attention to detail
- Excellent communication skills (written and verbal)
- Expert working knowledge of CPT-4, ICD-10-CM and HCPCS codes
- Great interpersonal skills
- Certified as a Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Professional Coder – Hospital (CPC-H), or Certified Coding Specialist (CCS)
- Proficient computer skills including word processing and spreadsheet
- Highly organized
- Ability to communicate coding concepts to medical staff and management and to work independently
- Ability to apply billing compliance program rules, regulations, policies and procedures
- Able to multitask efficiently and effectively
12 Coding Educator resume templates
Read our complete resume writing guides
1
Medical Coding Educator Virginia Resume Examples & Samples
- Coding Certification from either AHIMA or AAPC
- 2+ years of experience in MRA
- Strong attention to detail and exceptional follow up skills
2
MRA Coding Educator Resume Examples & Samples
- Certified Professional Coder (CPC) through AAPC
- Minimum 4 years active (current) coding experience
- Minimum two years coding / documentation training or instruction experience
- Strong knowledge of CMS federal and local regulations, HEDIS, HIPAA and CMS STARS requirements
- Exceptional attention to detail and analysis skills
- Demonstrated interpersonal, public speaking and presentation skills in one-on-one, small group, classroom, large group conference and auditorium settings
- Comprehensive technical knowledge of Microsoft Office applications, including Word, Excel, and PowerPoint
- Reliable transportation (personal vehicle) with ability to drive locally and long-distance with air travel as necessary
- Overnight travel, occasionally outside Texas, approximately 50% or as needed
- Certified Professional Coder-Instructor (CPC-I) through AAPC
- Anatomy / Medical Terminology instruction experience
- Proficiency in WebEx or similar platform delivery
3
MRA Coding Educator Resume Examples & Samples
- Coding certification through AAPC/AHIMA or a licensed clinician (LVN/RN) with education skills
- Ability to handle multiple tasks and deadlines with attention to detail
- Proficient in Microsoft Office applications, including Word, Excel, and PowerPoint
- Valid driver’s license & reliable transportation required
- Ability to drive locally and long-distance with air travel as necessary. Overnight travel, occasionally outside Texas (Travel-50%)
- Medical Coding/ Medical Terminology background; instruction experience preferred
- Working knowledge CMS federal and local regulations, HEDIS, HIPAA and CMS STARS requirements
4
Medical Record Coding Educator Resume Examples & Samples
- AAPC or AHIMA certification is required
- Comprehensive knowledge of Microsoft Word, Excel and Access
- Willingness to travel - This role will require National travel as business need dictates
- Extensive knowledge of ICD-(coding and medical record documentation)
5
.provider Coding Educator Resume Examples & Samples
- Must be skilled in Excel and PowerPoint
- Extensive teaching and instructing experience
- Extensive local and overnight travel, must have reliable transportation and valid drivers license
- Bachelor's degree or graduate preferred
6
Coding Educator Resume Examples & Samples
- 3+ years of Coding experience in an Acute Care Hospital setting with 1 year training experience; 2+ years of experience as a Clinical Educator
- Certified as a Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Professional Coder – Hospital (CPC-H), or Certified Coding Specialist (CCS)
- Excellent communication skills (written and verbal)
7
MRA Coding Educator Resume Examples & Samples
- Certified Professional Coder (CPC) certification through AAPC/AHIMA
- Excellent facilitation, consulting & delivery of complex content
- Strong organizational, interpersonal, communication and presentation skills
- Ability to drive locally; Overnight travel, occasionally
- WebEx Experience
8
Coding Educator Resume Examples & Samples
- Bachelor’s Degree in Communications, Education or similar field
- Working experience in Learning and Training tools like Webex required
- MRA background highly preferred
- CPC certification highly preferred
9
Coding Educator Resume Examples & Samples
- Perform face to face presentations at provider facilities
- Assist the business with research and documentation of workflows, policies and programs and other materials
- Assesses and identifies training opportunities
- Maintain current knowledge of ICD 10 coding compliance with risk adjustment requirements
- Certified Coder (CPC, CCS-P or CRC)
- Intermediate in Microsoft Office applications Word, Excel and PowerPoint
- Day travel required to provider facilitates and occasional overnight stays - Ability to travel up to 20% in the Central Phoenix area and some Northern areas of Arizona with possible overnight stays
- 5 plus years of coding experience and/or previous education/facilitator experience
- Working knowledge of Medicare Risk coding and CMS guidelines preferred
- Access experience
10
Traveling Senior Coding Educator Resume Examples & Samples
- Educate providers on Risk Adjustment methods and tools in order to comply with governmental regulatory guidelines
- Collaborate with team members in targeting assigned providers in need of Risk Adjustment training
- Initiate and build positive, consultative relationships with Providers and Medical Groups (as assigned)
- Conduct medical record review for assessment of coding documentation and HEDIS/Stars measures for accuracy based on the Risk Adjustment Model and ICD-10-CM coding guidelines
- Identify potential suspects through clinical documentation and reporting
- Schedule Provider meetings to review findings related to medical record review and reports
- Educate providers on how to improve their coding and documentation for Risk Adjustment
- Identify HEDIS/Stars gaps through clinical documentation and reporting
- Educate providers on outstanding measures and necessary means to close the HEDIS/Stars gaps
- Identify coding and documentation trends to develop and comprehensive Provider specific plan
- Implement education Providers and staff as needed regarding coding compliance, documentation guidelines, HCC education and Medicare/Medicaid regulations
- Collaborate with doctors, coders, facility staff, and a variety of internal and external personnel on a wide scope of Risk Adjustment education efforts
- Use independent judgment and decision making to field any Provider questions or concerns
- Utilize management appropriately for issues/concerns escalation purposes
- Work independently and rely on professional discretion and judgment; as well as a professional representation of Client/Optum
- Assist other team members in coding, HCC opportunities, and act as a resource to less experienced staff
- Maintain current knowledge of coding guidelines and relevant federal regulations with current ICD-10 CM knowledge
- Report to/works with the Manager of Clinical Quality & Coding
- Provide feedback and present solutions, to the Manager of Clinical Quality & Coding and team members (as warranted), regarding trends or patterns in Provider coding, documentation, HEDIS and /or Stars
- Enhance professional growth and development through in-service meetings, and educational programs
- Maintain strictest confidentiality based on HIPPA privacy policy
- Perform related work and projects as required
- Undergraduate degree or equivalent experience
- Must possess a CPC or COC certification or will agree to have it completed within 6 months of employment
- Must have experience with medical record documentation review and consulting with providers on improving documentation and coding
- Must have a strong understanding of medical terminology, disease process and anatomy and physiology
- Complete understanding of ICD-10-CM coding classification and guidelines
- Basic proficiency with MS Outlook, Word, Excel
- Must have good organizational, communication and presentation skills
- Must have strong interpersonal and excellent customer service skills
- Must be able to work independently and meet productivity requirements
- Ability to travel locally to provider practices - will be out in field 75% in assigned region/location, with possible non-local travel which could incur occasional overnight stay(s)
- Completed coding certification course, AAPC/AHIMA, or other accredited certifying body, or completed college courses with degree in coding or currently enrolled in program for CPC, COC, CRC, CIMC, CFPC, CPMA, CCS, CCA, CDIP, or RHIT
- Experience with face to face interaction with Providers and staff in communication of coding and documentation regulations and best practice
- Proficiency with SharePoint, MS Access
11
Medical Coding Educator / Analyst Resume Examples & Samples
- Provider education in a group or 1:1 environment based on production reporting, audit findings, provider feedback, OIG work plan areas
- Monitor physician profiles, identify trends, and areas of improvement
- Participate in the development of coding policies and billing guidelines and communicate appropriately
- Perform related work, including, but not limited to quality improvement projects and coding support for ancillary services
- Monitor corrective action plan effectiveness as determined by compliance audit findings
12
Icd-coding Educator Resume Examples & Samples
- Assists Regional Coding Teams & Health Information Management Managing Director in meeting coding quality & productivity goals & objectives by - identifying opportunities for continuous quality improvement
- Communicates & participates in operational & strategic regional planning
- Actively involved in designing & developing training modules as a means of mentoring & training in all functions & services related to hospital medical coding, medical documentation, physician queries, electronic health record abstracting & data collection
- Monitors coding & abstracting quality by conducting &/or coordinating ongoing audits in order to ensure that coding quality & performance improvement standards are achieved, maintained & or improved
- Works closely w/ the Coding Supervisors, HIM Directors as well as the members of labor unions to: develop, implement, evaluate & improve coder participation in the HIM Department Coder Training & Transition Programs
- Provides ongoing coding & systems education & training of staff through
- Monthly or bi-monthly CPT & ICD classification system training
- Health Connect end user training
- Answering coding questions posed by regional coders
- Provides Clinical Documentation Improvement training to staff through: Coordination of physician concurrent record review
- Provides all facets of Career Ladder Training to represented staff
- Focus training for employees undergoing "Reduction in Staff" (RIF)
- Provides Shared Services training as needed, such as: CPT & ICD classification system training for Regions Outside California (ROC)
- Development of training materials for Regions Outside California (ROC)
- Tracks & reports on the progress of trainees at each phase of program training
- Assists Regional Coding Team in preparing & analyzing statistical data in an effort to improve clinical patient outcomes
- Ensures compliance w/ all applicable federal, state & local regulations, as well as w/ institutional/organizational standards, practices, policies & procedures
- Strong research skills including knowledge of automated analysis tools & on-line research tools required to resolve complex coding/systems issues
- Must be able to work flexible days & hours
- This job description in not all encompassing
- Minimum four (4) years relevant experience assigning ICD-9-CM diagnoses and procedure codes, AMA CPT, and CMS HCPCS codes
- Minimum four (4) years combined experience assigning and auditing AMA CPT and CMS HCPCS codes, as well as ICD-10- CM/PCS and ICD-9-CM diagnoses and procedure codes in an acute care setting required
- Servicing Fontana and San Diego facilities
13
Coding Educator Resume Examples & Samples
- Serve as ICD-10 Subject Matter Expert (SME) providing on-going ICD-10 training in his/her individual market (other markets as needed) and be available to answer questions and provide guidance for physicians, providers and staff
- Assist Regional Coding Educator develop and conduct classroom, webex and/or on-the-job training for new and existing coders and providers with basic, specialty specific and HCC risk adjusted educational offerings for his/her individual market
- Assist Regional Coding Educator administer knowledge checks to ensure market coding staff are appropriately trained and have coding skill sets necessary to be successful within TPR and to be compliant with applicable compliance regulations
- Collaborate with Coding Manager, if applicable, to run quarterly E&M code utilization reports to monitor provider coding patterns and conduct spot checks of documentation for providers whose E&M patterns deviate from the norm
- Assist Market , Regional or National Coding Operations Manager to perform annual provider E&M documentation reviews of 5 encounters for all providers in the markets to ensure accurate selection of evaluation and management and procedure codes to be in compliance with Medicare, Medicaid and other payer requirements, as needed
- Develop provider education, as needed, based upon these reviews
- Assist in monitoring .edu and E&M University course completion, as needed
- Assist with individual market pre-bill clearance reviews, as needed
- Assist Regional Coding Educator to develop market specific coding education for providers and coders resulting from results of pre-bill clearance reviews
- Assist individual market coding staff with day-to-day coding duties, as needed, including but not limited reviewing provider documentation to ensure assignment and sequencing of procedural and diagnostic coding to ensure accurate and timely submission of claims
- Assist market coding staff with coding tasks, as needed, to ensure timely processing of payer denials and adherence to RCM KPI metrics
- Ensure compliance with Federal and State regulations; and
- Participate and complete special projects and other duties as assigned
14
Coding Educator Resume Examples & Samples
- Provides individual and group education/presentations to coding staff, physicians, and others throughout the organization that require coding knowledge; monitors and reports progress, to ensure compliance with coding standards and expectations
- Develops curriculum for individual and group diagnosis and procedural coding, and all related federal and state payment regulations
- Coordinates development of documentation improvement educational materials for physicians and other providers
- Research and evaluate coding, documentation practices, and processes and Identify coding trends through data analysis or chart review
- Provides leadership, while focusing on overall success
- Respond to questions and concerns from coding staff
- Works in conjunction with coding auditors to ensure continuous feedback and re-education if necessary
- Participates on ICD-10 implementation team for coding training and facilitates training sessions
- Attends weekly and monthly meetings
15
Inpatient Coding Educator Resume Examples & Samples
- Provide on-site ICD-10 education for hospital clients located nationally
- Present to a wide array of populations including support staff and senior leadership
- Educate these populations in a large number of topics including introductions to the ICD-10-CM/PCS systems, documentation specificity required by ICD-10, documentation improvement, general ICD-10 awareness, and other ICD-10 topics
- Research, design and develop education content when on-site education is not scheduled
- Work with the Director of ICD-10 Services and other ICD-10 Education Consultants to look for process improvements, streamline programs, maximize efficiency, and ensure all deliverables are met
- Strong skill set in classroom and webinar education
- The ability to conduct compelling presentations for coders, physicians, nurses, and other clinical populations in a style that will lead to successful adoption and knowledge transfer
- Confidence in dealing with multiple populations and handling a wide variety of questions
- Certification or familiarity with the ICD-10 transition is a requirement
- Extensive experience in clinical, coding and healthcare related research in relation to education and arbitration of advanced clinical subject matter
- Willing to travel upwards of 75% to deliver this education nationwide
- Bachelor's Degree in Healthcare Sciences or related field/equivalent experience
- 8+ years of Coding, HIM Management, and/or Clinical experience in a practicing role
- 4+ years of classroom training and education development experience
- Certification in ICD-10
16
Coding Educator / Analyst Resume Examples & Samples
- Maintain coding reimbursement and quality through training of providers and coding staff
- Provider education in a group or 1:1 environment based on production reporting, audit findings, provider feedback, OIG workplan areas
- Facilitates quarterly specialty coding meetings or in-services
17
MRA Coding Educator Resume Examples & Samples
- Current medical coding certification from AAPC (CPC) or AHIMA with ICD-10 proficiency
- Prior medical coding experience in an office setting
- Ability to travel around the region up to 75% of the time
18
Nurse Coding Educator Resume Examples & Samples
- Review, modify and develop materials for on boarding and training for HEDIS, disease conditions, ICD coding, etc
- Individual, small group, team in person and virtual educational sessions
- Work autonomously, multi-disciplinary, or intersegment teams
- Become a SME on HEDIS guidelines for out-patient and skilled nursing facilities
- Coordinate and develop quality assurance tools to support project related best practices and align the best practices with AAPC guidelines, OPTUM Coding policy, CMS regulations to ensure coding educator activity compliance and mitigate risk
- Active participation in field/remote coding educator activities for HEDIS and Risk Adjustment documentation and coding which may include chart reviews, audits, provider engagement activities , etc
- Travel at least 50% of the time
- Licensed Nurse (RN OR LPN) current and unrestricted in state of residence and ability to obtain multi-state or compact
- Current AAPC - CPC Coding certification or ability to obtain within six months of assuming role
- 1+ years of experience with HEDIS, Risk Adjustment and Quality projects
- Knowledge of CMS/Risk Adjustment Rules and Regulations
- Ability to travel at least 50% of the time throughout the US
- Professional, team oriented, and supportive
- Ability to create, build and maintain relationships across a variety of stakeholders
- Experience with working with deadlines and able to complete deliverables within constraints
- Excellent time management, organizational skills and ability to balance multiple priorities
- Goal oriented and ability to function in an ambiguous environment
- Experience with virtual and on site coding, audit, and educational activities
- Project / operational management experience
- Experience with intersegment and team collaboration
- MS Office Suite, moderate to advanced EXCEL and PowerPoint skills
19
Medical Oncology Coding Educator Resume Examples & Samples
- Conduct regular and on-going review of medical record documentation, for coding and documentation compliance. This also entails report generation and preparation to identify trends establishing a robust Coding/Training program
- Review, research and respond to practice billing and coding within a designated timeframe
- Collaboration with Research, Physicians and Central Business Office teams participating in project calls and dashboard creation. Aiding in appeal coordination with Patient Assistance Support
- Collaboration with Managed Care regarding payer contracts
- Collaboration/partnering with Revenue Cycle Management regarding payer related issues
- Researches, prepares, and develops coding material that will be presented to network practice physicians, clinical team and business staff via on-site, web based, and other methods of training
- Development of coding tools/aids
- Coding changes/annual webinar
- Five (5) Years Medical Oncology, Evaluation and Management (E&M) Chemotherapy Teaching, and Infusion Therapy coding. Maintaining Compliance and Regulatory Guidelines for network communication
- Must be familiar with government regulations and applicable reimbursement laws and regulations
- Thorough knowledge of CPT-4 procedural coding methodology with ICD-10, ICD-9 diagnosis and HCPCS coding
- 2 years project management experience
20
Coding Educator Specialist Resume Examples & Samples
- Demonstrated computer skills, and proficiency with MS Office Suite
- Extensive knowledge of third party physician reimbursement, billing regulations and managed care field
- Demonstrated strong verbal and written communication skills, including report writing skills
- Excellent interpersonal skills, and ability to work with a diverse constituent population
- Demonstrated organizational and prioritization skills, and ability to be detail-oriented
- Demonstrated ability to work independently, make decisions and take initiative while exercising sound judgement
- Ability to be flexible with work schedules and adjust to deadlines
21
Outpatient Medical Coding Educator Resume Examples & Samples
- Education: Bachelor’s degree in Health Information Management or related field. Master’s degree in a health-related discipline or education preferred
- Experience: Minimum of five (5) years progressive coding or coding review experience
- Licenses/Certifications: Registered Health Information Management Administrator (RHIA) or Registered Health Information Technician (RHIT) and Certified Coding Specialist (CCS) from the American Health Information Management Association (AHIMA) or Certified Outpatient Coding Specialist (COC) required
- Develops and administers curriculum for students to acquire the knowledge and skills necessary for competency in ICD-10 coding
- Administers admissions process for Coding school
- Assesses course effectiveness through student evaluations
- Works with System Services coding management team to establish coding program and monitor the success of the coding program including assisting with student recruitment
- Advises current coding trainees relative to their performance and maintains appropriate documentation
- Actively participates in the development and implementation of standardized organization-wide coding guidelines and documentation requirements and implement training and educational programs for coding specialists
- Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service
22
Medical Coding Educator Resume Examples & Samples
- Education: Bachelor’s degree in a health-related discipline or education required. Master’s degree in a health-related discipline or education preferred
- Experience: Minimum of five years progressive coding or coding review experience in ICD-9, ICD-10 and CPT/HCPCS with working knowledge of the MS-DRG/APC structure and regulatory requirements
- Licenses/Certifications: Certified Coding Specialist (CCS) required from the American Health Information Management Association. Registered Health Information Management Administrator (RHIA) or Registered Health Information Technician (RHIT)
- Develops and administers curriculum for students to acquire the knowledge and skills necessary for competency in ICD-9 and ICD-10 coding
- Instruct students in the coding trainee program along with developing instructional materials to include course plans, objectives, and evaluation tools
- Develops and administer an annual coding school budget
- Works with System Services coding management team to establish coding program and monitor the success of the coding program including assisting with student recruitment. Advises current coding trainees relative to their performance and maintains appropriate documentation
- Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff
23
Coding Educator Resume Examples & Samples
- Serves as a liaison between Corporate Revenue Cycle functions and Director of Coding
- Lead training sessions on current billing and coding information in the medical field
- Develop curriculum and training handbook and create presentations
- Perform quality assurance reviews to assess comprehension of training efforts and assure coding quality
- Review and respond to coding questions
- Research updated coding information and communicate changes to physicians and billing staff
- Provide continual coding and payer updates
- Maintain knowledge of ICD-9 (ICD-10) and CPT classifications and coding of diagnoses and procedures
- Identify elements of a medical record's structure and content and code abstracting
- Convert hand-written medical charts to code
- Works closely with physicians to ensure that charges are being accurately and compliantly being captured, coded, and billed compliantly
- Builds strong relationships and facilitate effective communication between hospital and physician-based Revenue Cycle
24
Coding Educator Resume Examples & Samples
- Responsible for: Assists with developing, supporting and providing coding education and training to Physicians and staff
- Responsible for: Providing communication feedback loop from Coding and
- Reimbursement/Business Office to Physicians and Staff on coding and reimbursement issues
- Responsible for: Development and maintenance of encounter forms and preference lists utilized by Dreyer Medical Clinic
- Responsible for: Coordinates functions and activities of department
- Responsible for creating and presenting an orientation program on coding and charge capture expectations with new hires and/or contracted physicians/providers
25
Coding Educator Resume Examples & Samples
- Conduct training sessions on provider-based coding and billing guidelines
- Develop educational curriculum and associated training materials
- Create presentations
- Perform quality assurance reviews to assess comprehension of training efforts
- Organize and participate in coding and reimbursement meetings
- Research and provide updated coding information
- Communicate coding/billing updates to physicians and billing staff
- Conduct coding reviews and associated training programs to ensure coding quality
- Ensure billed services are accurately coded
- Must possess an extensive knowledge of coding, billing and compliance across a broad range of specialties. Must also have experience working with Medicare and Medicaid coding requirements
- Ability to apply billing compliance program rules, regulations, policies and procedures
- Ability to communicate coding concepts to medical staff and management and to work independently
- Expert working knowledge of CPT-4, ICD-10-CM and HCPCS codes
26
Provider Coding Educator Resume Examples & Samples
- Assist in the development of educational materials, policies and procedures, training programs and educational tools for coding staff, Provider Relations and outside physician offices
- Provide coding feedback and trends to leadership
- Will be relied on as coding subject matter expert of the organization, and will represent the organization in dealing with vendors, delegated entities, providers and the Centers for Medicare and Medicaid Services (CMS)
- Collaborate with internal departments to conduct an annual risk adjustment readiness assessment including an analysis of readiness for a CMS risk adjustment data validation audit and provide recommendations to management for strengthening the RPM program
- Maintain knowledge of risk adjustment regulatory requirements and serve as an internal resource for departments in implementing coding and process changes needed to meet compliance
- Knowledge of coding, billing and compliance across a broad range of specialties and experience working with Medicare coding requirements
- Experience in conducting audits and medical record reviews
- Experience with CMS Medicare Advantage Risk Adjustment Data Validation Audits Preferred
- Clinical work experience preferred
- Professional verbal and written communication skills, with the ability to clearly articulate thoughts and ideas
- Organizational skills with the ability to handle multiple tasks and/or projects at one time
- Analytical and interpretation skills including departmental, utilization, financial and operations data
- Creative thinking skills with the ability to ask the needed bigger-picture questions that lead to process and team improvements
- Time management skills with the ability to prioritize and schedule daily activities for the most efficient use of time
- Interpersonal skills with the ability to work in a fast-paced environment and participate as an independent contributor with little supervision or as an active team member depending on the situation and needs
- Bachelor's degree or equivalent work experience preferred
- AHIMA or AAPC coding certification required
- RN or LVN license preferred
- Ability to present effectively to large groups
- Must be able to multi-task, be highly self-motivated, prioritize projects, and meet deadlines
- Demonstrated ability to consistently produce high quality work in a timely and appropriate manner
- Minimum two years of coding experience using ICD-9-CM, CPT-4 and HCPCS
- Experience developing and implementing policies and procedures to maintain CMS compliance
- Proven background developing actionable reports to drive improvement in the organization's performance
- Proven experience determining key business issues, developing effective action plans and implementing interventions to bring about successful conclusions
- Personal computer experience should include working with Microsoft Word, Excel, PowerPoint and Outlook at the intermediate level at a minimum
27
Compliance Coding Educator / Auditor Resume Examples & Samples
- Solid analytical skills with the ability to look at the big picture impact, experience with project management a plus
- Demonstrated ability to apply a high standard of coding accuracy
- Demonstrated ability to work independently and use critical thinking skills to problem solve
- Excellent written and verbal communication skills. Ability to express complex issues and situations in clear and understandable terms. The ability to understand and carry out oral and written instructions and to request clarification when needed
- Demonstrated skill in operating a PC computer, skill using word processing, strong experience in Excel (e.g., pivot tables), database, e-mail, and Internet applications on a PC in a Windows environment
- Ability to maintain and enforce confidentiality of sensitive information
- Ability to respond with flexibility and efficiency to frequent changes in task focus, competing priorities, and multiple deadlines
- Ability to thoroughly analyze problems, perform research, formulate logical conclusions and/or alternatives, make recommendations, and implement solutions
- Ability to work quickly and accurately with close attention to detail
- Ability to compose reports, letters, instructions, emails, and other documents with attention to clarity, tone, composition, and mechanics
- Ability to motivate, develop and direct people to accomplish objectives
- Acts with confidence, builds credibility and trust
28
Coding Educator Resume Examples & Samples
- Adheres to all Northwest Community Hospital standards, policies, and procedures
- The level of knowledge usually obtained through the completion of four years of high school or the equivalent
- Registered Health Information Administrator or Registered Health Information Technician is required. Certified Coding Specialist certification preferred
- Requires a minimum of three years hospital medical record experience including one-year supervisory experience
- Proficiency in Federal and State regulations as well as Coding Clinic guidelines
- Proficiency in health information computer systems required. Familiarity with Microsoft Office products such as Excel, Word, Access, etc. desired
- Excellent oral and written communication skills necessary to express ideas effectively
- The analytical skills necessary to identify opportunities for improvement, utilizing reports, observations or feedback from others
- Service oriented demeanor a must with the interpersonal skills necessary to effectively communicate and interact with all levels of hospital personnel, physicians, patients, and outside agencies
- Proficient computer skills including word processing and spreadsheet
29
Medical Coding Educator Resume Examples & Samples
- Focusing on potential documentation improvement opportunities and issues by specialty for E&M and surgical clinicians
- Train new providers and faculty staff on E&M coding of their professional services
- Review remittance advises for rejection resolution and training opportunities
- Work with various leadership and departments, including the departments of Billing, Compliance and Professional fee Coding to determine areas of both risk and opportunity
- Provide information and training on regulatory updates and standards to PBS Staff
- Assist with the development and /or revision of SuperBill templates as may be required from time to time
- Provide suggestions on appropriate documentation to ensure complete and accurate billing that reflect current demands of regulatory and third party payers
- 6 years of related experience in a healthcare setting
- LI
30
Medical Coding Educator Resume Examples & Samples
- Develops and publishes educational materials for practitioners and coding staff adhering to the overall coding application and approach of American Anesthesiology
- Responsible for the education of all practitioners on an annual basis, in response to audit findings, new hires, and inquiries
- Responsible for the education of all coding personnel in the general coding principles and guidelines set forth by the organization as a result of audit findings, annual updates, new hire orientation, or as requested on a divisional basis
- Maintains memorialization of all educational activities with established tools and methodologies
- Provides both verbal and written reports on any educational activities
- Assists in the identification, creation, management and updating of all Educational Plans
- Assists in the development of Educational Action Plans for newly contracted Practices
- Provides analysis and summation of audit findings from both internal and external sources
- Serves as a liaison divisionally with regard to coding and compliance questions
- Researches coding and compliance issues related to Practices' new service development (e.g., intensivists, acupuncture, social workers, etc.)
- Reviews coding and compliance journals, publications and appropriate websites to keep informed of new coding changes and compliance issues, rules and regulations
- Assists in the education of American Anesthesiology staff regarding any updates, revisions, and clarification to coding and compliance rules/regulations nationally
- Assists in the development and performance of physician education sessions related to compliance and coding issues
- Assists in the development, review and revision of billing forms and tools, including staff guidebooks (e.g., ASA cross-reference), and guidelines for Contracted Practices and staff
- Assists in the maintenance of the billing systems coding dictionaries (such as diagnosis, CPT codes, and ASA-CPT crosswalk) to ensure proper submission of claims
- Stays abreast of changes, trends and developments within field of specialty (Anesthesia)
- Participates in administrative staff meetings and attends other meetings and seminars as requested
- Assists in the evaluation and communication of audit findings, department or individual reports, to practitioners and other departments of the organization
- Recommends new approaches, policies, and procedures to influence continuous improvements in department’s efficiency
- Takes ownership of special projects, researches data and follows through with detailed action plans
- Actively participates in problem identification and resolution and coordinates resolutions between appropriate parties
- Adheres to American Anesthesiology, Departmental and HR policies and procedures
- Bachelors Degree in Business Administration, Health Care Administration or other related field is preferred but not required
- Certification by a nationally recognized coding and accreditation program that requires CEU submission for renewal
- Three to five years coding experience preferably in anesthesia and/or general surgical
- Must have experience with chart auditing techniques and physician services coding techniques and regulations
- Excellent written and oral communication skills, public speaking skills and problem solving capabilities
- Ability to recognize and maintain confidentiality
- Proficient in Microsoft Office products including but not limited to Power Point and Excel
- The ability to travel up to 50% of the time is required
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Coding Educator Resume Examples & Samples
- Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Professional Coder (CPC), or Certified Coding Specialist (CCS) certification
- Two (2) to five (5) years’ experience in a relevant role
- 94% accuracy on organization’s coding test
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HIM Certified Coding Educator Resume Examples & Samples
- Knowledge of medical terminology, anatomy, physiology, and other related studies
- Typing skills
- Expertise in oral and written communication skills to clarify/discuss coding issues with physicians and/or co-workers
- Ability to work with co-workers in a team situation and to take initiative in performing additional tasks
- Demonstrated instructor ability or experience
