Job Description
Job Description:
The Coding and Documentation Education Specialist is responsible to teach and provide expert advice in CPT (Current Procedural Terminology) and ICD (International Classification of Diseases) coding guidelines, clinical documentation, risk adjustment methods, billing and revenue integrity policies, denials analysis and prevention to the medical staff and associate staff. The Education Specialist proactively analyzes and interprets the revenue and reimbursement implications of clinical documentation as it is translated into ICD and CPT codes, charge capture, and risk adjustment methods. The research, analysis, education and recommendations contribute to compliant optimization of revenue and quality measures. Also, prepares and leads medical staff and associate staff education on CPT and ICD-10 related payer coverage policies, documentation of medical necessity, risk adjustment factors, e.g., hierarchical condition categories (HCC). Interprets...