What are the responsibilities and job description for the Professional Coding Educator Auditor Specialist position at Xtensys?
General Summary
We are new but mighty. Xtensys, a recently established managed service provider, delivers cutting-edge technology to health systems, starting in NY and expanding beyond. Owned by two industry leaders focused on innovation in rural and community health, we are rapidly growing with several major initiatives underway. We are seeking a skilled Professional Coding Educator Auditor Specialist to join our team of 500 and support our exciting journey. We value people and are building a culture to match.
Job Summary
Under the direction of the Revenue Cycle Supervisor and Manager, the Coding Educator Specialist is responsible for reviewing and auditing documentation and coding across and within multiple specialties utilizing proper CPT, ICD-10-CM, HCPCS and modifiers. Responsibilities include providing reports of audits, provider education, and support for coders with any identified compliance issues. Medical Coding workload will be assigned as needed. The ideal candidate will have a keen eye for detail and accuracy when reviewing medical records and assigning the correct codes. Strong written and verbal communication skills are essential for effectively collaborating with physicians and healthcare providers. The Revenue Cycle team operates independently but remains flexible and cooperative to ensure departmental goals are achieved.
Job Responsibilities include
Education – High school diploma or equivalent with additional course work at approved coding seminars or courses. Coding Certification with AAPC or AHIMA required, such as RHIT, CCS, CPC, etc. Certified Coding Auditor (CCA, CPMA) or Certified Professional Medical Auditor is a plus.
Experience – A minimum of 3-5 years coding experience preferred. Must have knowledge of ICD-10, CPT-4, and HCPCS coding for physician billing and current knowledge of E/M standards and specifications. Reimbursement and billing experience in Medicare B, Medicaid and other third-party payers and data entry experience in a physician billing environment a plus. Epic experience also a plus.
Physical Requirements – Lifting up to 20 pounds, standing or sitting for extended periods of time, as well as repetitive use of hands and fingers.
We are new but mighty. Xtensys, a recently established managed service provider, delivers cutting-edge technology to health systems, starting in NY and expanding beyond. Owned by two industry leaders focused on innovation in rural and community health, we are rapidly growing with several major initiatives underway. We are seeking a skilled Professional Coding Educator Auditor Specialist to join our team of 500 and support our exciting journey. We value people and are building a culture to match.
Job Summary
Under the direction of the Revenue Cycle Supervisor and Manager, the Coding Educator Specialist is responsible for reviewing and auditing documentation and coding across and within multiple specialties utilizing proper CPT, ICD-10-CM, HCPCS and modifiers. Responsibilities include providing reports of audits, provider education, and support for coders with any identified compliance issues. Medical Coding workload will be assigned as needed. The ideal candidate will have a keen eye for detail and accuracy when reviewing medical records and assigning the correct codes. Strong written and verbal communication skills are essential for effectively collaborating with physicians and healthcare providers. The Revenue Cycle team operates independently but remains flexible and cooperative to ensure departmental goals are achieved.
Job Responsibilities include
- Work closely with various departments across the Medical Centers, including interacting with physicians and healthcare providers to clarify documentation and ensure accurate coding.
- Attend all mandatory annual educational programs required for the position and participate in AAPC/AHIMA webinars related to assigned specialties to stay updated on coding practices.
- Initiate actions to bring documentation into compliance with coding standards under the direction of the Coding Manager.
- Develops, implements, and monitors annual auditing/review schedule with goals and deadlines as directed by the Coding Manager and Coding Supervisor.
- Works with coders to identify any on-going documentation trends and develops education strategies to improve any identified lapse in documentation compliance.
- Provides on-going coding and documentation review using documentation guidelines as well as education and support for providers as needed.
- Attend all Coding Department meetings and other meetings as directed by Coding Manager.
- Conduct audit of medical records and coding practices to ensure adherence of quality standards and regulatory requirements.
- Conduct one-on-one and group training sessions to address audit findings or performance gaps.
- Serve as the go-to resource for coding questions from providers and coding staff.
- Track educational outcomes and adapt content to meet evolving needs.
- Support onboarding of new coders with role-specific education.
- Achieve established quality and productivity goals as defined by the department
- Ensure coding practices comply with government regulations (e.g., HIPAA, Medicare) and insurance guidelines, maintaining high levels of accuracy in code assignment.
- This job description outlines typical duties but is not exhaustive of all tasks that may be assigned to the position.
Education – High school diploma or equivalent with additional course work at approved coding seminars or courses. Coding Certification with AAPC or AHIMA required, such as RHIT, CCS, CPC, etc. Certified Coding Auditor (CCA, CPMA) or Certified Professional Medical Auditor is a plus.
Experience – A minimum of 3-5 years coding experience preferred. Must have knowledge of ICD-10, CPT-4, and HCPCS coding for physician billing and current knowledge of E/M standards and specifications. Reimbursement and billing experience in Medicare B, Medicaid and other third-party payers and data entry experience in a physician billing environment a plus. Epic experience also a plus.
Physical Requirements – Lifting up to 20 pounds, standing or sitting for extended periods of time, as well as repetitive use of hands and fingers.