Consultative Coding Professional

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• 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 Address:

• 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 Athena One EMR.

+ 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