Senior Coding Consultant

Req No
2017-4047
Category
Production Coding
Type
Regular Full-Time

Overview

The Senior Coding Consultant is responsible for reviewing medical records to determine whether the documentation substantiates the coding of the claims submitted for reimbursement.  Audits are performed based on the client’s needs focusing on coding, abstraction and billing compliance utilizing the official coding rules.  Additionally, this position is responsible for providing educational presentations to stakeholders and coders. 

 

Peak Health Solutions, an AMN Healthcare company, is an EEO/AA/Disability/Protected Veteran Employer We encourage minority and female applicants to apply

Responsibilities

  1. Provide comprehensive compliance coding reviews that reflect findings and recommendations in a timely, professional manner.
  2. Uses reference materials and tools to validate coding and abstracting to ensure correct payment.
  3. Tracks trending analysis to identify patterns and variations in coding/billing practices.
  4. Provide consultative service and subject matter expertise in general and select coding related services.
  5. Produce reports highlighting findings of audit, opportunities for improvement, and detailed commentary to the client
  6. Develops written reports summarizing findings and presenting to client
  7. Create educational materials and content based on audit findings
  8. Conduct client education sessions to review findings, recommendations, and best practices
  9. For RAC and denial management assignments create appeal letters to defend hospital coding based on medical record documentation and official coding guidelines
  10. For coding preceptorship assignment servers as a coding mentor for client and Peak preceptorship educational programs
  11. Ability to manage multiple client engagements
  12. Comply with internal coding compliance monitoring plan relative to quality measures. Consultants shall achieve and maintain minimal accuracy of coding compliance of 95% during review of audit work product.  Senior Coding Consultant staff shall comply with internal productivity benchmarks established by Peak.
  13. Communicate effectively with management, co-workers, clients, physicians, and other customers to ensure collaboration.
  14. Maintain current knowledge and expertise of coding guidelines, coding updates and regulatory requirements.
  15. Maintain professional credentials (AHIMA, AAPC) satisfying all required CE hours (auditors responsibility). Senior Coding Consultants may take advantage of any internal coding education programs.
  16. Provide documentation of annual education courses completed during annual evaluation.
  17. Share knowledge base and provide internal coding consulting services as a member of the Peak team.
  18. Promotes efficient use of expenditures and resources (expense reports, timesheets) in accordance with budgetary guidelines

Qualifications

  • RHIA or RHIT, and/or CCS Mandatory: AHIMA ICD-10 Approved Trainer preferred
  • 2 years of coding consulting experience
  • 5 years of coding experience
  • Clinical Documentation and/or Inpatient coding experience with report writing and presentation expertise
  • Knowledge of the medical record, ICD-10 principles and documentation requirements
  • Must be detail oriented and have the ability to work independently
  • Computer knowledge of MS Office, Excel, Adobe, MS Word, and MS PowerPoint
  • Must display excellent interpersonal skills
  • Ability to write reports independent of management review
  • Colleague is responsible for maintaining continuing education credits as required by
    credentialing organization
  • Ability to occasionally travel up to 10% if necessary

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