Provider Educator

JOB SUMMARY:

SPECIFIC RESPONSIBILITIES:

• Works directly with our providers to review their individual audits, provide education and feedback
• Collaborates with our auditor to review audits, set up audit schedule and give feedback
• Conducts education/training and presents final audit findings to department staff, physicians and appropriate individuals
• Is stationed in our clinical settings to provide one-on-one coding assistance after providers see patient
• With technical direction and assistance from management, along with our auditor, designs and implements coder education program, continuing education programs and Medical Staff education programs
• Establishes and monitors performance and maintains appropriate documentation thereof
• Reviews, develops and delivers training programs and educational materials to address deficiencies identified in the audits compliant with regulatory requirements
• Depending on location, provides or arranges for education/training of facility healthcare professionals in use of coding guidelines and practices, proper documentation techniques, medical terminology and disease processes as it relates to clinical data quality management factors
• Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, according to regulatory requirements
• Promotes cooperation with compliance programs to improve documentation which supports compliant coding
• Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching plans in accordance with federal and state regulations and guidelines
• Participates with management in the assessment of external audit findings and responds as needed
• Validates the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems, missed secondary diagnoses and procedures and ensures compliance regulatory requirements
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and Corporate Compliance Coding Guidelines
• Assures compliance with the coding guidelines and regulatory requirements
• Other duties as assigned

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

KEY COMPETENCIES:

• Communication Skills

Effectively and respectably communicate with other individuals, whether it be a colleague, patient, or patient’s family member and appropriately enumerate information in a manner easily understood by all parties. We do this to foster a culture of understanding between all parties, especially in complex and difficult situations, to ultimately provide the best care possible to our patients and their families.

• Decision Making

Ability to make the most appropriate decision in a given situation and then taking the next steps to ensure appropriate and timely completion. This requires conflict resolution skills, critical thinking skills, confidence in your ability to make the right decision in most situations. This also includes ability to prioritize your workday appropriately to ensure the most important tasks are completed on time.

• HealthCare Knowledge

Having the drive to keep yourself abreast and up to date on the new breakthroughs in your area of expertise and communicating them to the rest of the team, as appropriate.  This also includes keeping up with your licensure and yearly training requirements within your area expertise along with MAHEC’s organizational training. Finally, the ability to apply the depth of knowledge maintained and gained through this process in real life scenarios as appropriate.

• Interpersonal Skills

Showing the ability to meet difficult situations with grace, professionalism, and understanding. Within your area of expertise, showing respect and showing empathy where appropriate with your colleagues, patients, and their family at all times, even when its most difficult to do so. This is done, in part, by effective listening, being your authentic self, showing responsibility and dependability, and being patient with others.

• Organizational Values

Adherence to MAHEC’s founding principles and incorporating them every day. This includes, among others, having integrity and accountability, reverence for other cultures and equitable practices, ability to manage change, and displaying a clear understanding of organizational dynamics. Doing these things creates a culture where people want to do the best for each other and gives personal ownership towards the goal of helping people in their time of need.

• Problem Solving

Having an analytical mind and ability to work autonomously to solve complex problems that may arise. The wherewithal to think logically through a difficult problem and come to an appropriate resolution for a given issue. This helps to drive continuous improvement by thinking through where we can improve in a novel way. Measures success by understanding where we are currently and where we want to go and then applying those new ideas to affect positive change.

SPECIFIED SKILLS

COMPUTER

• Excellent skills in Microsoft Office including Word, Excel, PowerPoint, and database applications required.

ADDITIONAL INFORMATION

• Ability to perform duties with speed and accuracy
• Ability to think strategically
• Ability to work independently and to initiate and complete tasks with minimal supervision required  
• Must be a team player 
• Must demonstrate discretion in dealing with medical, fiscal and personnel information as is appropriate to position.
• Requires the ability to appropriately and professionally handle multiple and competing priorities

EDUCATION AND EXPERIENCE

MINIMUM QUALIFICATIONS:

• High School Graduate or equivalent
• National certification from the American Health Information Management Association (AHIMA) as a Certified Coding Specialist (CCS) or certification through the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC)
• Previous experience in Healthcare Administration, Billing & Coding experience in OP or IP setting

PREFERRED QUALIFICATIONS:

• Strong education/training background in coding and reimbursement
• Veridigm (Allscripts) PM experience
• Endcoder experience

SCHEDULE:

Regular attendance on-site is an essential function of this position; includes some remote work and flexible work schedule. Typical business hours are Monday – Friday, 8:00 am to 5:00 pm (or flexed to best meet the needs of the organization),40 hours per workweek; weekend, holiday, or evening coverage is occasionally required.

POSITION COMPENSATION:

$27.88/hour, full time + full benefits available

At MAHEC, we strive to equip all team members with Total Rewards (pay + benefits) to honor their service, support their health, manage their financial security, build their career, and thrive.

All MAHEC employees and learners will be required to receive the Flu vaccine or have an approved exemption.

MAHEC Talent Management is located at 121 Hendersonville Road, Asheville, NC 28803. Equal Opportunity Employer.

MAHEC is a qualifying employer for the Public Service Loan Forgiveness (PSLF) Program. Employees who meet federal requirements may be eligible to have remaining student loan balances forgiven after 10 years of qualifying payments while working full-time at MAHEC.

If you are interested in this role, and you have related experience and qualifications, we encourage you to apply or reach out to [email protected] for support in your job search process. You could be the talent we are seeking for this or other opportunities.