• Provides and arranges training for coding professionals in the use of coding guidelines and practices, proper documentation techniques, medical terminology, and disease processes. Develops and provides at least quarterly education to coding, billing and other staff regarding emerging topics critical to accurate ICD and CPT coding.
• Serves as trainer to physician group on documentation criteria.
• Performs periodic claim form reviews to check code transfer accuracy from the abstracting system and other various systems.
• Assists the management with training of new coding staff related to coding guidelines, encoder and other software systems needed for the coding process, etc.
• Assigns codes based on coding guidelines, Coding Clinic directives, federal regulations, CCI coding initiatives, CPT Assistant or other standard coding guidelines.
• Assists with review of coding guidelines on an annual basis and makes recommendations for change to improve coding and data management.
• Develops coding policy and procedure or position papers related to correct coding for new or emerging technology services provided by clinical staff, and train coders on the use of that policy and procedure.
• Performs quarterly coding assessments on all staff coders and recommends training and education as an outcome of the audits as well as recommends career ladder for coders based on audit results.
• Evaluates the effectiveness of education and training programs.
• Responsible for being the system wide coding contact person.
• Serves as primary Recovery Audit Contractor liaison for coding items.
• Formulates appropriate responses to agencies attempting to reduce and retract reimbursement.
• Mitigates paybacks through record review and education.
• Implements changes resulting from internal and external audits which impact performance.
• Analyzes results and identifies patterns, trends and variations in coding and documentation practices.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.