Coding Provider Educator

Remote within NC, NC, OK, AR, OR, WA, NY, CA, CT, DE

, | Billing

Position Summary:

This is a remote position. Must reside within NC, NC, OK, AR, OR, WA, NY, CA, CT, DE.

Provider Audits/Education:

Provider Educator will audit, educate and monitor providers for EM levels, office procedures and diagnosis coding adhering to the audit and training schedule set forth in the GoHealth Coding Audit Protocols. Maintain accurate records of the provider audits and make any recommendations for changes in policies and procedures, guidelines and training programs. Develop and conduct provider training and maintain a positive learning experience.

Must be available for day and evening phone/web training when needed.

JOB REQUIREMENTS

Education
  • High School Diploma or GED required
  • Bachelor’s Degree preferredï‚
Work Experience
  • Minimum of 5 years out patient EM/office procedure coding
  • Minimum 2 years training providers on chart documentation and coding guidelines
  • Knowledge of revenue cycle
  • ïExperience with delivering presentations, conducting one on one education with providers, teaching a coding class, or speaking at coding seminars
Licenses/Certifications
  • Medical Coding Certificate – RHIT, CPC, or CCS-P
  • ICD10 Proficiency
Additional Knowledge, Skills and Abilities Required
  • Federal laws and regulations affecting coding requirements
  • Working knowledge of payor guidelines
  • Knowledge of billing practices
  • Knowledge of EMR required, eClinical Works and/or Epic preferred
  • Knowledge of PowerPoint, Microsoft Word and Excel
  • Strong communication skills.
  • Excellent interpersonal skills
  • Organizational skills
Additional Knowledge, Skills, and Abilities Preferred
  • Denial Management
ESSENTIAL FUNCTIONS

Provider Audit/Education Duties:
  • Performs focused audits, reviewing medical record documentation that supports billing, risk management and legal requirements. Works closely with Corporate Compliance to assist in identifying where there is a need for improved coding compliance and documentation
  • Develops and implements onsite education and training to all provides to ensure accurate documentation and coding in real time. Serves as a consultant to all providers, helping them to improve documentation and proper coding and ensuring maximizing reimbursement
  • Develops and implements coding education for all new hire providers. Works with Compliance to ensure timely baseline audits and re-audits, providing necessary identified educational sessions.
  • Performs data analysis, evaluating denial reports of all payers; reporting on physician statistics regarding coding compliance, benchmarking and revenue enhancement opportunities
  • Participates in committees and meetings as it pertains to coding, billing, and documentation
  • Prepares written reports of the audit findings by provider/practice
  • Assists with claim denial reports to ensure optimal reimbursement
  • Provides clarification on GoHealth coding and compliance policies
  • Meets with the Compliance Committee as needed to review audits, discuss concerns, make plans for processes/procedures
Required knowledge, skills and ability:

Customer service skills:
  • Ability to represent the Department in a professional manner when interacting with patients, guests,
  • physicians and their staff
  • Ability to handle issues professionally
  • Ability to follow through with customers
Communication Skills:
  • Ability to communicate effectively to providers regarding audit results
  • Ability to communicate effectively to centers and staff regarding departmental policy
Keyboard skills:
  • Ability to type proficiently
Teamwork:
  • Ability to function effectively as extension of the Center
  • Be flexible and open-minded in thought processes
  • Maintain focus under pressure
  • Share relevant information with other team members
Note: this job description is not inclusive of all the duties of the position. You may be asked by leaders to perform other duties. Management reserves the right to revise this position description at any time.

All qualified persons are granted an equal opportunity for employment without regard to race, color, religion, sex, sexual orientation and gender identity or expression, age, national origin, citizenship status, disability, genetic information, medical condition, family care leave status, pregnancy or pregnancy-related condition, otherwise qualified disabled or veteran status. The company will comply with all fair employment laws in each of the jurisdictions where we conduct business.


Keywords:
Job, emergency, healthcare, licensure, medical, clinical, wellness, career, employment, opening, staff, benefits, health care, clinic, primary care, urgent care


Why GoHealth?

GoHealth Urgent Care has outstanding career opportunities in Connecticut, Delaware, Missouri, New York City, North Carolina, Northwest Arkansas, Oklahoma City, San Francisco and the Portland-Vancouver area. And all of these positions have one thing in common: flexibility to practice urgent care medicine the way it was meant to be, without the stress and bureaucracy of hierarchical organizations. With reasonable work hours that don’t emotionally exhaust them or burn them out, our team can balance and prioritize their professional and personal lives.