Provider Educator (Coding Coordinator)

Education, Training, Content Development, Regulatory Updates • Facilitate comprehensive onboarding for new providers to ensure a strong foundation in billing, coding, and documentation requirements. • Deliver timely updates to stakeholders (providers, coders, departments, RevCycle, leadership) on legislative, regulatory, coding, billing, and documentation changes. • Identify training needs and collaborate on the development and delivery of educational programs and materials tailored to specific audiences. • Maintain and expand the centralized Resource Library, ensuring easy access to accurate and up-to-date educational materials. • Provide ongoing education, feedback, and support to enhance compliance and accuracy in documentation, coding, and billing. • Translate complex coding, billing, and regulatory information into user-friendly, accurate educational materials. • Create and deliver presentations tailored to specific internal and external audiences, ensuring relevance and clarity, and addresses the needs of the stakeholders. • Monitor and analyze changes in industry regulations, payor policies, CPT codes, and compliance requirements. • Develop and deliver education sessions to ensure stakeholders stay informed of evolving standards and regulations. Audits, Reviews, and Projects • Conduct provider audits and routine departmental audits for hospital-based (HB) and professional-based (PB) coding. • Perform risk-based audits, including reviews of outliers, denial trends, and upcoding/downcoding patterns. • Lead proactive audits (e.g., RAC, TPE, OIG, CBR) to identify and mitigate compliance risks. • Conduct ad hoc audit and other review requests from coding teams, providers, departments, leadership, and RevCycle, providing actionable feedback and recommendations. • Planned and special projects as assigned. • Other ongoing work related to education, billing, coding, documentation, etc. • Execute various projects, from ad hoc to long-term, by developing problem statements, defining scope, and managing timelines and resources to ensure successful outcomes. • Support colleagues with projects and engage in mentorship opportunities to build team knowledge and skills. • Work on strategic initiatives, such as automation, denial prevention, and billing for underutilized services (e.g., care management, telehealth). Advisory, Assistance, Advocacy, and Collaboration • Serve as a resource for resolving complex coding queries, disputes, and documentation challenges. • Research and respond to inquiries from providers and coders, offering clear and actionable guidance. • Develop and update policies, guidelines, and workflows for coding, documentation, and billing to ensure compliance and efficiency. Mentorship and Team Development • Provide mentorship and guidance to junior team members, supporting their professional development and knowledge growth. • Foster a collaborative and supportive environment within the Provider Education team. Other duties as assigned • Associates degree in Healthcare, Business or related field; AND • 5 years of production coding experience; OR • Equivalent combination of education and experience. • Certification in CPC, CPC-H, RHIT, or RHIA. Knowledge, Skills, and Abilities • Strong knowledge of coding guidelines, regulations, and documentation requirements. • High degree of coding accuracy and ability to retain and appropriately apply multiple complex coding concepts. • Intermediate skills with Word, Excel, Outlook, and PowerPoint. • Excellent communication, presentation, and interpersonal skills. • Willingness to be on camera and appropriately attired for all online meetings. • Proficiency in educational program development and delivery. • Familiarity with healthcare compliance principles. • Experience with electronic health records (EHR). • Commitment to staying current with industry developments and continuous learning. • Bachelor’s in related healthcare field. • 5+ years of auditing and provider or coder education experience in multiple specialties. • Additional certifications. • Associates degree in Healthcare, Business or related field; AND • 5 years of production coding experience; OR • Equivalent combination of education and experience. • Certification in CPC, CPC-H, RHIT, or RHIA. Knowledge, Skills, and Abilities • Strong knowledge of coding guidelines, regulations, and documentation requirements. • High degree of coding accuracy and ability to retain and appropriately apply multiple complex coding concepts. • Intermediate skills with Word, Excel, Outlook, and PowerPoint. • Excellent communication, presentation, and interpersonal skills. • Willingness to be on camera and appropriately attired for all online meetings. • Proficiency in educational program development and delivery. • Familiarity with healthcare compliance principles. • Experience with electronic health records (EHR). • Commitment to staying current with industry developments and continuous learning. • Bachelor’s in related healthcare field. • 5+ years of auditing and provider or coder education experience in multiple specialties. • Additional certifications.