Coding Compliance Educator T5

Coding Compliance Educator

Experienced candidates may be eligible for a sign-on bonus of up to $5,000. 
Early-career candidates may qualify for up to $11,000–$17,000 in tuition forgiveness.

United Health Services is seeking a Coding Compliance Educator to join our UHS team in Binghamton, NY. This position ensures that the coding of diagnosis, procedures and data complies with all coding rules, laws and guidelines.  

This is a benefits eligible position

Shift: Days
Hours per week: 40 hours per week
Salary range: $27.47-$41.21

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Coding Compliance Educator Overview

Responsible for the coordination of activities to monitor physician documentation in the medical record in regard to applicable regulations and billing to support services rendered. Provides education to physicians and coders regarding documentation improvement opportunities for both facility and/or professional billing. Researches, analyzes, and responds to inquiries regarding coding and documentation compliance in accordance with all coding guidelines and Medicare/Medicaid regulations. Assist with coding, documentation, and billing questions to ensure compliant coding and billing. Develop education materials to address issues or new requirements and be able to present to providers or other appropriate staff members. Helps identify areas for education opportunities based on industry performance, regulatory focus areas and risk areas within the organization.

Key Responsibilities and Expectations

• Provides ongoing education to coders and UHS providers to maximize compliance and reimbursement. Represents UHS and the HIM Department in on-site meetings to provide support and training for both new and established providers.
• Assesses coding accuracy and compliance with policies and procedures and identify areas of potential risk. Performs, reviews, and/or delivers scheduled provider and coder audits. Provides support for Coding Compliance Committee through the preparation of summary reports.
• Follows Coding Compliance standards and branding when communicating with clinical partners and fellow business center teams. Works collaboratively to solve billing and coding issues with Physician Billing Services, Insurance and Customer Service Representatives, Clinical Managers, Compliance team and UHS Internal Auditing team.
• Employs strong understanding of the healthcare revenue cycle, as well as a working knowledge of Medicare, Commercial, and HMO insurance, including the impact on reimbursement. Utilizes medical reference resources and contacts to thoroughly research coding issues and maintain working knowledge of payment/reimbursement systems to ensure maximum reimbursement and coding compliance.
• Analyzes coding related denials, edits and/or charges to help identify and correct reimbursement deficiencies, to identify opportunities for coding optimization, education/training, and to deter non-compliant coding behaviors.
• Analyzes bell curve reports or other financial data to determine whether there is variation from national averages and/or UHS peers due to inappropriate coding, insufficient documentation, or missed revenue opportunity.
• Inspires the trust and respect of the coding team and helps increase coder productivity and quality through on-going education and support, motivating the team to achieve both department and organizational goals.
• Acts as a collaborative partner to the Coding Directors and Supervisors to enhance overall coding team performance. In addition, acts as a resource for UHS Practice Managers and Supervisors, Medical Group Directors, System Support and other staff.
• Maintains knowledge of CPT and ICD-10 coding principles and guidelines.
• Maintains current knowledge on the legislation changes, changes in CPT, ICD-10-CM codes, and coding guidelines - changes in the rules and guidelines of all major payers.
• Maintains a membership in AHIMA and/or AAPC and meets the requirements for obtaining CEU’s to maintain their certification..

Position Qualifications

Minimum:

• High School Diploma (or equivalent) plus CPC, CCS and/or RHIA certification or Associates Degree in HIM with RHIT certification, within 6 months of hire
• One year of experience in Coding, Billing, or Provider Education

Preferred:

• RHIA certification with a Bachelor’s Degree in HIM Associate’s degree in related field such as Health Science 
• 3 years of education experience in the health care field

License/Certification

Minimum Required:

• RHIT, RHIA, CCS or CPC

Preferred:

• Not applicable

Employee Benefits at United Health Services

When you work at United Health Services, you become part of our family. We’re proud to offer competitive benefits and compensation to our employees who make an impact every day.

• Health, dental, and vision insurance
• Voluntary benefits, including cancer, pet, and life insurance
• 403(b) retirement plan with company match model
• Immediate accrual of paid time off
• Wellness program rewards and insurance discounts
• Employee Assistant Program (EAP) counseling and concierge services
• Free, extensive online training through HealthStream

About United Health Services

United Health Services is a not-for-profit healthcare system serving more than 500,000 people in Upstate New York’s Southern Tier region. We offer integrated healthcare services across 60 locations, including four hospitals, three walk-in centers, and 22 primary care offices, in addition to home care services and senior living facilities. The United Health Services system employs more than 6,300 people and comprises 600+ providers who are all committed to providing and supporting the delivery of exceptional patient care.

United Health Services employees and providers are “LOVED!” This means we’re Living Our Values Every Day. Here, you’ll join a team that is dedicated to values-based, coordinated patient care. Every day, we outwardly live our Values of Compassion, Trust, Respect, Teamwork, and Innovation.

About New York’s Southern Tier

As an employee of United Health Services, you’ll call the Southern Tier, or more specifically, the Greater Binghamton area, home. Known for entertainment and restaurants, craft brews, outdoor experiences, minor-league sports, family-friendly events, and a keenness for local history (like our connection to the Twilight Zone and our six antique carousels), Greater Binghamton offers something for everyone. We’re a short drive away from the Finger Lakes region in Central New York, three hours from New York City, and just shy of four hours from Niagara Falls, Canada.

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United Health Services in an Equal Opportunity Employer.

United Health Services, Inc. and the members of the UHS System neither are affiliated with, sponsored, endorsed nor approved by, nor otherwise associated with, Universal Health Services, Inc. (NYSE: UHS), UHS of Delaware, Inc. nor their affiliates, which can be found at www.uhsinc.com.