Coding Educator - Validator

1. Perform inpatient and outpatient medical record audits to validate appropriate diagnoses and procedures based on coding guidelines and insurance regulations.

2. Abide by AHIMA standards of Ethical Coding when performing validation reviews and provide feedback to Sr. Coding Manager of any potential compliance issues related to coding and physician documentation.

3. Provide guidance and education to Coders on validation findings to support compliant coding and increase knowledge and skills.

4. Conduct regular educational sessions with Coders (and other hospital staff as needed) on newly published coding guidelines or billing regulations to assure coding staff possess accurate information and follow new requirements.

5. Develop curriculum and training materials for staff learning ICD-9-CM / ICD-10-CM and CPT coding.

6. Revise and provide recommendations of best practice standards for coding policies and procedures.

7. Assess physician documentation and provide recommendations for coding strategies and physician queries that aim to improve hospital severity and mortality data.  Will also provide regular education to Clinical Documentation Specialists (CDS) as needed.

8. Assist in review and assessment of audit findings from third parties that provide coding validation audits.  Formulate and write appeals when appropriate and/or educate Coder(s) when required. 

9. Provide coding support and answer coding questions for Patient Financial Services and other departments.

10. Maintain up-to-date working knowledge of all coding and reimbursement rules and regulations.  Must be able to assign modifiers correctly and assist in working edits when necessary.

11. Must stay current in all areas of coding and maintain continuing education units to remain credentialed.
 

• Minimum of 5 years inpatient coding experience in an acute care facility required.
• AHIMA CCS credential and AHIMA approved ICD-10 Trainer required.
• AHIMA RHIT or RHIA preferred.
• Experience performing outpatient coding preferred.
• Must possess excellent communication skills.
• Siemens Soarian and 3M experience preferred.
• Working knowledge of Microsoft Word and Microsoft Excel required.