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Senior role within Clinician Services for Medical Specialties, focusing on coding, documentation, data analysis, and cross-functional collaboration to support strategic decision-making and compliance.
Job Responsibility:
Monitor and analyze KPIs to identify trends and transform data into actionable reports and presentations that support strategic decision-making
May participate in Service Line leadership meetings to represent Clinician Services, share updates, propose improvements, and align departmental efforts with organizational strategy
Collaborate with leadership and cross-functional teams—including Coding, CDI, CMD, Integrity Operations, Optimization & Technology, and Clinical Informatics—to identify improvement opportunities and advance documentation practices
Provide operational and technical guidance to staff and stakeholders, ensuring clarity and consistency in documentation and coding processes
Demonstrate compliance with regulatory requirements, including CMS, QIOs, NCCI edits, and payer-specific guidelines, while adhering to AHIMA’s Standards of Ethical Coding
Utilize EHR systems and coding tools proficiently, maintaining data integrity and supporting efficient documentation workflows
Maintains confidentiality of patient records
Reports any perceived non-compliant practices to the Clinician Services leadership or compliance officer
Engage in continuous learning, staying current with evolving coding guidelines, practices, and terminology through training and professional development
Promote a collaborative, service-oriented culture, modeling professionalism and teamwork across Clinician Services and organizational stakeholders
Requirements:
Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) certification, or Coding Specialist (CCS) certification, or Coding Specialist – Physician (CCS-P) certification issued by the American Health Information Management Association (AHIMA) or Professional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC)
Specialty credential required
Completion of advanced training through a recognized or accredited program, equivalent in scope and rigor to post-secondary education or equivalent knowledge
High school diploma or GED required
5 years of experience in expert-level professional and/or facility coding, and experience in collaborating with other teams within an organization, and/or educating/training licensed clinicians
Advanced level of ICD-10- CM/PCS and/or ICD-10-CM/CPT/HCPCS for a large complex health care system or medical group
Extensive knowledge of third-party reimbursement programs, state and federal regulatory issues, national and local coverage determinants, research-related restrictions, ICD-10 CM/PCS, and CPT/HCPCS coding classifications
Proficiency in statistical analysis
Demonstrated proficiency in the Microsoft Office Suite (Word, Excel, PowerPoint, Teams, etc.) or similar products and in patient accounting and billing systems
Ability to deal and work effectively with multiple departments and in matrix organizational structures
Strong understanding of medical terminology, anatomy, and physiology
Highly proficient in problem-solving and analytical thinking with strong attention to detail
Advanced knowledge of Epic and other reporting tools
Nice to have:
Advanced training beyond High School that may include the completion of an accredited or approved program in Medical Coding and/or Associate or Bachelor’s degree
Specialty credential through AHIMA, AAPC or HFMA
What we offer:
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Opportunity for annual increases based on performance