Job Description

Job Summary
Perform coding quality audits on outpatient records to assure appropriateness, accuracy, and compliance for CPT/HCPCs, ICD-10-CM code assignments, and modifier assignment in accordance with Center of Medicare and Medicaid Service (CMS) Guidelines, AMA and AHA Official ICD-10-CM Coding Guidelines. Provide ongoing feedback to managers and coders. Develop and implement educational programs regarding elements of the coding compliance program and act as a subject matter expert for the outpatient coding department.

Mission Statement
Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.

Responsibilities*
Characteristics, Duties, & Responsibilities:

OPERATIONS

Perform pre and/or post bill secondary chart review to validate modifier selection, E&M, procedural, and diagnosis coding in accordance with established coding guidelines
Provide workflow and coding training to new hires
Continuously provide feedback to coding staff to improve code selections that accurately describe the procedures and services performed by physicians in accordance to NCCI, AMA/CPT & ICD 10- guidelines
Review and Dissect coding clinics, yearly AMA guidelines, ICD-10-CM and NCCI to prepare education sessions to outpatient coders.
Develop and coordinate educational and training programs regarding elements of the Coding Compliance Program, such as appropriate documentation, accurate coding, and coding trends found during chart reviews.
Respond to complex internal and external customer inquiries in relation to Mid-Service processes, documentation, and coding compliance standards.
Participate in process improvement initiatives by use of technology
Revise and/or write Policies & Procedures related to Revenue Cycle Mid-Service
Assist with coding in the event of an unplanned emergency
Demonstrate initiative by the continuous expansion of knowledge and skills
Participate in department/unit activities including, but not limited to, staff meetings and in-services
Perform other duties as assigned to maintain the efficiency of the department
Protect the confidentiality of primary and secondary health records and the information therein as mandated by law, professional standards, and Health System policies
Demonstrates excellent customer service skills in working with Revenue Cycle staff, clinicians, and other UHMS staff. Model, support and reinforce a culture of service excellence
SKILLSET

Extensive CPT/ ICD-10-CM coding knowledge with a strong understanding of the AMA, AHA and NCCI Official Coding Guidelines and how to apply them.
Ability to leverage technology for process improvement.
Analyze guidelines to provide in-depth education to staff.
Write appropriate queries to the clinical care team in accordance with the AHIMA Query Policy.
Attention to detail with thoroughness and accuracy when accomplishing a task.
Participate as an active member of Lean Thinking in daily work initiatives
Excellent verbal and written communication skills, analytical thinking, and problem-solving skills with attention to detail are required.
Proficiency in organizational skills and planning with an ability to juggle multiple priorities in a fast-changing environment
Experience in developing and providing education to coders and physicians
Ability to work independently, be self-motivated, and the ability to adapt to the changing healthcare environment.
Required Qualifications*
Associate's degree in healthcare related field or an equivalent combination of education and/or experience.
Certified Professional Coder (CPC), or Certified Outpatient Coder (COC), or Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS/CCS-P) credential.
Three years' experience coding or auditing CPT, ICD-10-CM, and modifier assignment.
Extensive knowledge of federal and state regulations and policies pertaining to documentation and coding.