Consultative Coding Professional

Become a part of our caring community The Consultative Coder provides medical coding expertise to support clinical staff (Physicians and Advanced Practice Providers) to ensure the documentation within medical records supports diagnostic and procedural coding.

Location:

This is a Hybrid role candidate(s) must reside in South Carolina. You will report to Director, Medical Coding.

Relationship/Concierge Services:

Cultivate relationships with clinicians (Physicians and Advanced Practice Providers) to serve as the single contact for questions and issues relating to documentation and coding. Based on one-on-one engagement with clinicians, identify documentation improvement areas and partner with clinical and coding education to deliver education related to improvement opportunities Analyze trends, assessment, and answer questions in real-time. Research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues.

Post-Visit/Offshore Coding Collaboration:

Perform Quality Assurance on post-visit reviews. You will determine frequency and sampling methodology) Review the encounter for potential missed opportunities. Address nonbillable services at the provider level. Address documentation deficiencies resulting in not billable services promptly (missing chief complaint, missing time for audio only visits, and missing telehealth platform) Work with provide updates on documentation requirements and process changes.

Mergers and Acquisitions:

Responsible for the special handling of

Mergers & Acquisitions:

Perform Problem list cleanup (as outlined by compliance) Conduct PCO Process training including reporting for open notes and addendums, and gap attestation process and performance expectations. Train acquired providers on PCO documentation requirements and processes.

Other Responsibilities:

Lead Special Projects within the Division/Markets As requested by Market leaders, perform the following tasks: Analyze AWV completion rates (what criteria is needed to complete AWV) Analyze EDAPS; report the variances between datahub and eCW. Conduct Chart reviews to identify educational opportunities. Perform individual chart research. Collaborate with HEDIS leaders and champions to identify HEDIS gaps and deficiencies. Participate in Payer calls/chart reviews. Compile payer findings and assist with research. Participate in payor meetings/discussions to ensure accurate data submission.

Required Qualifications:

Three years Medical Coding experience or similar (including IPA and Offshore coding management) RHIA, RHIT, CCS, or CPC Certification Anticipated location and overnight travel are