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Job Objective: A brief overview of the position.
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Establishes and monitors clinical documentation and coding initiatives that support quality and level of care related to revenue cycle objectives while meeting all compliance requirements. Conducts strategic needs analyses and develops/recommends strategies toward implementation of effective systems and processes. Provides subject matter expertise, guidance, and leadership to support organizational process improvement related to Epic system and other technology.
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Reports to
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• Director-Clinic Billing Services
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Supervises
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- N/A
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Ages of Patients
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- N/A
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Blood Borne Pathogens
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- Minimal/ No Potential
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Qualifications
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Education
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o Required: High school diploma, GED or higher level degree
o Preferred: Bachelor’s degree
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Licensure/Certification
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o Required: Certified Documentation Improvement Expert (CDIE); plus Certified Professional Coder (CPC) from American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIM);
o Preferred: Certified Professional Biller (CPB) from AAPC
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Experience
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o Required: Three (3) years of coding and clinical documentation review experience with one (1) year of experience collaborating with healthcare providers, coding or revenue cycle
o Preferred: Experience developing and delivering documentation and coding education to physicians, residents, and ancillary staff
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Essential Responsibilities
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1. Demonstrates compliance with Code of Conduct and compliance policies and takes action to resolve compliance questions or concerns and report suspected violations.
2. Adheres to the AHIMA Code of Ethics and takes action to resolve compliance questions or concerns and reports suspected violations.
3. Follows departmental policies and procedures to support organizational goals and objectives.
4. Coordinates with coding and clinic leadership to develop strategic and operational plans related to clinical documentation, coding and coding education to support revenue cycle initiatives.
5. Collaborates with coding and denials team to develop, implement and maintain a coding training program through certification, including creation of curriculum, internships and pretest mentorship.
6. Maintains expert level knowledge of clinical documentation and coding processes; develops and implements initiatives that result in improved efficiency and financial performance.
7. Serves as Liaison between facility/coding team and vendor(s), as appropriate.
8. Develops and implements processes to provide coding and documentation feedback to coders and providers.
9. Analyzes claim denial and audit data related to coding, medical necessity issues and clinical documentation; works with coding and liaisons to create corrective action plans and initiates education as appropriate.
10. Develops and delivers documentation and coding educational programs to ensure providers and coding staff remain compliant with accreditation and regulatory requirements.
11. Collaborates with Payor Relations and Clinic Operations to develop strategic and operational plans and work flows based on insurance contracts.
12. Remains active in AAPC and AHIMA programs sharing information as appropriate.
13. Collaborates with Medical Staff Services and providers to support and expand clinical documentation improvement initiatives and deliver education as appropriate.
14. Performs other duties as assigned.
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Located in the heart of the Coachella Valley, you have access to resort-style living and world-class amenities throughout Southern California.
