Manager, Billing & Coding Educational

POSITION SUMMARY

The Billing & Coding Educational Manager is responsible for the education and training of providers, residents, fellows & students rotating through the organization, and other necessary staff on coding requirements. This position works closely with the VP, Controller Revenue Cycle and VP, Chief Revenue Officer. This position is a key role in supporting the organization’s compliance with federal, state and other guidelines including those related to the designation of a Federally Qualified Health Center (FQHC) and ensuring providers, residents, fellows, students, and other necessary staff are educated and well informed of coding requirements and relevant changes on a timely basis.

Work is typically performed in an office environment, but this position may have the option to work from home. The specific statements for this job description are not intended to be all inclusive. They represent typical elements considered necessary to successfully perform the job. 

REPORTING RELATIONSHIPS

The position reports to the VP, Controller Revenue Cycle. No staff report to this position.

ESSENTIAL JOB DUTIES and FUNCTIONS

While living and demonstrating our Core Values, the Billing & Coding Educational Manager will:

• Develop, implement and maintain billing and coding educational materials used in clinical provider and learner training, including the creation and ongoing maintenance of training protocol documents of the clinical workflow, including Medent usage
• Develop, implement and maintain population management learner training program addressing inpatient/outpatient chart review.  Provide meaningful feedback and ongoing support and monitor to ensure residents have the knowledge needed 
• In conjunction with the VP, Controller Revenue Cycle and VP, Chief Revenue Officer, responsible for the rollout of education to providers, learners and other necessary staff through direct engagement
• Deliver structured education on coding and documentation requirements during the annual new learner orientation, incorporating detailed billing and coding reference materials into the organization’s learner PowerPoint presentation
• Monitor monthly learner pace card metrics related to Billing and Coding and collaborate with appropriate GME leadership to provide targeted education when performance benchmarks are not consistently met by learners
• Develop and implement standardized audit process to review sample charts and educate the providers/ learners based on findings
• Create an audit process to review the quality of the documentation and coding of providers / learners 
• Conduct ongoing quality audits to review documentation and delivery of care plans/goals  
• Member of the internal audit committee for CPT and documentation compliance 
• Ensure ongoing compliance for all providers / learners on coding selection, and documentation to minimize any payer and governmental audit risk 
• Educate providers / learners based on approved education schedule as well as feedback from billing team resulting from claims processing 
• Develop a rotation schedule and ensuring a physical presence throughout clinical venues to field onsite questions and aid with coding and documentation 
• Serve as Billing Department representative at clinical huddles, didactics and other clinical meetings
• Serve as Billing Department representative at monthly, organizational-wide Department Compliance meetings.
• Attend meetings such as weekly operations meetings, staff meetings, and others as required. Must have capacity to attend meetings during day/evening as needed within assigned areas
• Educate and train medical scribes on coding and documentation compliance 
• Perform monthly chart audits of completed progress notes and orders and provide feedback to providers / learners. Communicate results including necessary information to billing team to appropriately reprocess claims for compliance and financial reporting 
• Assist other members of the team with projects as needed 
• Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations 

QUALIFICATIONS

• Bachelor or Associate degree in any Healthcare related field or equivalent experience
• 3-5 years of physician training experience required
• Excellent customer service skills required
• Excellent verbal and written communication skills required
• Must possess team leadership skills and have a positive disposition
• Knowledge of Microsoft Office software
• Must be focused, self-directed, organized, and have demonstrated problem-solving abilities
• Accurate and precise attention to detail 
• Able to work both independently and as part of a team
• Working knowledge of Microsoft Excel, Word, and PowerPoint, with experience creating and delivering presentations, preferred.
• Understands the “big picture” and is able to juggle multiple priorities