Coding Representative

We are seeking an experienced On-site Provider Coding Education Representative. In this key position the successful candidate will be outgoing, detail-oriented and responsible for the ongoing coding education and training of physicians and physicians offices in an effort to increase the overall focus on the importance of ICD-9 coding specificity. Involvement in chart reviews resulting from patient inquire reports, comprehensive medical chart reviews and the review of health medical records.

Responsibilities include:Updating manager and team on the status of education sessions, qualified offices, etc. Updating the coding team and various internal departments on the status of Health Management Reports. Updating manager and team on the status of PDM process, Comprehensive Chart reviews and other coding initiatives Reporting to Provider Relations on status of initiatives and identified issues with physician offices.

EducationResponsible for the training/education of physician and physician offices through one-on-one and mass communication Work with Project Manager in the development of education materials Work with Project Manager in the inclusion of relative information in provider newsletters, MyQuest, provider manual and web site Coordinate educational workshops with expert coder and physician offices. Work with Project Manager in identifying those physicians/physician offices requiring education. Work with Expert Coder on the "qualification process" of physician/physician offices and track progress of qualifications on a regular basis. Responsible for working with Project Manager on the education of contracted vendors relative to PDM process and other external audits being conducted related to risk-adjustment Serve as resource for physicians and physician offices on coding-related questions Serve as resource for Medical Management and Provider Relations on understanding coding through claims and referral data. Responsible for updating Project Manager on the status of education sessions, qualified offices. etc. Work with Member Service Representative/Concierge on the review of 4/12 report to identify those physicians and members requiring calls. Responsible for updating Project Manager on the status of PDM process and other coding initiatives Work with Project Manager on the reporting of monthly/quarterly/yearling improvements in overall network coding scores Report to Provider Relations on status of initiatives and identified issues with physician offices Determining/communicating/resolving escalated office concerns Recognition and resolution of network wide issues Acceptance by providers as a "resource" Act as a "resource" for network operations department, as needed Update offices and providers on Policies and Procedures through distribution of memos,updates to orientation manual and personal visits Work closely with coding team on the collection of data/reports Responsible for being primary contact/resource with contracted coders in the field Other duties as assigned Required SkillsMust be a Certified Coder - CPC, CCS, CCS-P RN or LVN Texas Licensure preferredRequired ExperienceCollege degree preferred or equivalent years of industry work experience required Managed care experience preferred (2 years) or 4 years work experience in an office environment Experience with presenting to large groups Extensive knowledge of ICD-9-CM outpatient diagnosis coding guidelines Available for evening coding-related meetings and training sessions. Physician/Hospital chart auditing experience required