Coding Quality Education Specialist

Essential Functions:

• Audits charts and revies clinical records ensuring all diagnostic and procedural codes and modifiers strictly adhere


• Identifies trends in improper coding or other communication shortcomings that may lead to claim denials or audits


• Complies with all medical coding guidelines and monitors evolving regulatory and industry changes


• Provides targeted education, direct coaching, and facilitates training programs tailored to each medica specialty upon translating audit findings


• Follows up and clarifies any information that i s not clear with the rendering provider


• Collaborates with IT and EHR teams to improve charge automation and optimize workflows


• Conducts ad-hoc audits to ensure fidelity to coding guidelines


• Relevant expert for Southwest Network on accurate and efficient coding practices


• Analyze medical records and identify documentation deficiencies

Nonessential Functions:

• Follows policies and procedures and adheres to the requirements of the Corporate Compliance Program


• Ensures confidentiality of verbal and written information in accordance with HIPAA standards and Southwest Network policy, and adheres to the legal, ethical and professional guidelines adopted by Southwest Network


• Other duties as assigned