Summary of Position
This position is responsible for auditing, training and monitoring of medical information and the quality of coding and provider documentation for Premier HealthNet, Premier Health Specialists and Upper Valley Professional Corp collectively known as The Premier Physician Network (PPN). This position will report directly to the PPN Clinical Documentation Improvement (CDI) & Coding Quality Manager.
Nature and Scope
The Coding Analyst is responsible for the research, training, and follow-up of coding and provider documentation compliance which affect the operations and reimbursement of the Network. The Coding Analyst will act as an on-call resource; conduct physician and staff training with regard to coding and documentation compliance, and chart audits. This Analyst will consult with CDI & Coding Quality Manager regarding documentation issues and practice patterns. The candidate will interact with physicians, practice managers, office staff, corporate staff, as well as hospital based and non-hospital-based resources.
Qualifications
The candidate must demonstrate successful presentation techniques and possess excellent organizational, customer service, and both oral and written communication skills. He/She should possess a strong knowledge base of ICD-10-CM, CPT and HCPCS coding, financial analysis techniques, costing, federal and state regulatory processes, insurance billing, third party payor requirements, outcome measurements, medical information management and practice patterns. He/She should also have advanced knowledge of Microsoft 365 (Word, Excel, PPT, Teams).
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Certification: CPC, CCS-P, RHIA, RHIT, or CCA. Must possess or obtain a nationally recognized coding credential from AAPC or AHIMA within 18 months of hire. Continued employment in this role is contingent upon successfully passing the credentialing exam within this timeframe.
Experience: Two (2) years experience with physician office coding.
Demonstrated working knowledge of professional billing
Experience with Epic EMR preferred
