• Review existing educational materials and augment as needed
• Develop plan to provide inpatient physician medical billing and compliance education leveraging data and existing knowledge to focus on the highest impacted areas including both inpatient and outpatient
• Works closely with project manager to design and implement comprehensive medical billing, compliance and charge capture education plan
• Provide in person targeted education at standing physician meetings, focusing on the highest impacted areas or service lines
• Implement performance measurement model and audit process
• Remediate areas of underperformance and noncompliance
• Create ongoing maintenance and roll-out education plan

Essential Skills:

• Experience with both clinical and billing/coding
  • Specific to level of care, in inpatient and outpatient settings
  • Knowledge of AMA CPT codes, ICD-10 diagnosis codes, and billing modifiers
  • Knowledge of provider billing of CPT codes and the association of accurate diagnosis codes based off level of care, time spent with the patient, and overall services provided
  • Knowledge of provider billing based off medical decision making (MDM)
  • Knowledge of patient admission and discharge process and management
  • Understanding of shared visits between provider/resident or APP and how to appropriately bill
  • Understanding of bedside procedures and how to bill compared to overall time spent with patient
• Able to interpret clinical documentation and translate to billable codes, based off the scope and complexity of services provided
• Ability to audit patient documentation and analyze trends that uncover potential deficiencies with accuracy and/or non-compliant provider charging
• Ability to collect analysis and structure findings with presentation that speaks to a provider's language
• Experience with putting together a comprehensive, long term, training program and providing training
• Ability to support PM with creation of training material, facilitation of inpatient physician charge capture education program
  • Expectation to be the main SME for inpatient and outpatient physician charge capture education program

Preferred Qualifications:

• Experience with cancer centers
• Experience with teaching hospitals and Resident billing
• Clinical Documentation Improvement Background
• Coding Background
• Epic experience