What are the responsibilities and job description for the EPHO Coding Specialist position at Emerson Hospital?
Job Summary
Under the directions of the Program Director of Population Health, this position will be responsible for reviewing patient charts prior to upcoming visits in order to alert the provider to conditions they should consider assessing. This position will interface with EPHO Providers and their staff in order to develop collaborative, productive relationships.
Job Functions
Run report of patients’ upcoming visits.
Review charts of those patients scheduled to see their physician.
Using a chart review template, identify potential diagnoses that have gone undetected or undocumented, and add these conditions to the EMR Problem List.
Compare diagnosis on the patients’ problem lists to current year billing records to determine which conditions, if any, haven’t yet been captured.
Alert provider of identified potential diagnoses via a reminder in the EMR.
Develop and maintain a tracking system to measure whether recommendations are followed.
Attend meetings with TMP Medical Director, administration and medical billers and coders as necessary.
Review and analyze patient records according to current compliance policies.
Review patient records and compare with billing system for potential chronic conditions that are present but have not been captured by ICD10 code in the billing system.
Document results of all coding audits and suggestions for coding and documentation improvement. Presents the findings to director, providers and other internal departments.
Create positive relationships with all providers and office managers.
Educate and train providers on how to utilize available tools to improve their knowledge and coding skills while staying within the guidelines.
Maintain up to date knowledge of the current changes of coding practices by continuing education and reading resource material.
Provide knowledge expertise in coding and risk adjustment for EPHO
Demonstrate strong written and verbal communication skills
Demonstrate excellent interpersonal skills in all interactions
Develop positive working relationships with physicians and staff
Demonstrate ability to work independently, displaying good clinical judgment and decision-making skills
Minimum Qualifications
Education
RN graduate of an accredited school of nursing and currently licensed to practice in Massachusetts.
Experience
1-3 years healthcare experience/medical terminology and coding (CPT/ICD9), medical record review
experience, ICD-10, CPT and HCPCS coding experience/proficiency required in a medical office environment
Licensure and/or Certification
None required
Skills
Excellent knowledge of HCCs, risk adjustment methodology and diagnostic criteria.
Strong written and verbal communication skills; strong analytical, organizational and time management skills