Job Summary
The Coding Compliance Educator is responsible for providing ongoing coding, documentation, and compliance education to providers and office staff. The role includes conducting chart audits, offering feedback and training, and ensuring compliance with payer and CMS requirements. This position requires strong communication skills, a background in medical coding, and the ability to act as an effective educator.
Key Responsibilities
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Orientation & Training (35%) – Provide education for new providers and staff (including locum tenens and residents) for up to six months.
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Ongoing Education (25%) – Deliver monthly training sessions for physicians, non-physician providers, and staff through small-group presentations.
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Complaint & Concern Reviews (25%) – Investigate and respond to documentation or coding issues related to patient or payer complaints, denials, or concerns.
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Chart Audits (15%) – Conduct bi-annual chart audits, perform pre-reviews, provide feedback, and communicate the impact on WRVU.
Additional Duties
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Complete OIG audits as required.
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Monitor and analyze utilization benchmark reports compared to CMS norms.
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Assist providers with difficult case coding.
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Maintain proficiency with Microsoft® Windows, Word, Excel, and PowerPoint.
Certifications & Licensure
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Required: CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist – Physician Office).
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Preferred: RHIT (Registered Health Information Technician) or RHIA (Registered Health Information Administrator).
Education & Experience
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High school diploma or GED required.
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4 years of medical field experience.
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2 years of physician coding and billing experience.
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1 year of direct physician contact experience.
Skills & Competencies
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Strong interpersonal, written, and communication skills.
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Effective educator, organized, and self-motivated.
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Knowledge of medical terminology and anatomy.
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Ability to manage multiple tasks and exercise judgment.
Physical & Working Conditions
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Sedentary role with occasional lifting (0–10 lbs).
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Exposure to stressful situations and potentially infectious materials.
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Requires mobility throughout the facility, use of PPE, and ability to handle frequent sitting, standing, and walking.