Provider Services Auditor Educator
St. Luke's University Health Network
Allentown, PA
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JOB DETAILS
LOCATION
Allentown, PA
POSTED
30+ days ago
The Provider Services Auditor & Educator is a certified medical coder who serves as a primary resource (auditor and educator) to assigned St. Luke’s Providers, Leadership, and Support Staff, Coders, and Billing Staff around professional coding and compliance. The Coding and Compliance Educator position is high profile and requires a candidate who is proactive, mature, dynamic, consistent with professional appearance and demeanor, and has the ability to develop and maintain positive strong relationships through challenging situations.
This position requires a solid understanding of complex coding principles, guidelines, and concepts and can broadly apply those guidelines resulting in effective auditing and education to assigned services/departments, coding and billing teams. It also requires a broad exposure and knowledge of the general healthcare landscape and the historical and current trends across the healthcare revenue cycle spectrum.
JOB DUTIES AND RESPONSIBILITIES:
+ Assess, design, facilitate, develop, implement and evaluate coding and documentation efforts to ensure we achieve optimal coding outcomes and remaining complaint with the policies of the network, state, federal and third-party guidelines.
+ Organize, facilitate, perform, track, trend, and report on internal quality reviews based on compliance plan and/or independent data analysis. Develop action plans working directly with providers and staff to address identified issues and improve overall documentation and coding.
+ Develop and deliver education in varied settings including large group presentations, classroom, small group forums, and 1:1, classroom, MEL for assigned departments/specialties. Demonstrates expertise in teaching and learning process. Able to understand and flex communication style to meet the learning needs of the audience.
+ Serves as coding/documentation expert for assigned areas. Helps to resolve problems and recommends solutions, including documentation design in the EMR, where there is opportunity for improvement. Maintains current knowledge of coding, compliance and documentation guidelines and trends for assigned departments/specialties.
+ Actively identifies opportunities for improvement, concerns, and trends and develops and implements action plans for such findings. Evaluates and communicates outcomes based on data and metrics chosen to demonstrate success of the plan.
+ Collaborates with medical staff to develop and implement education training associated with new technologies, procedures and quality related to coding and documentation.
+ Presents standard education modules including but not limited to new provider orientation
+ Conducts research using credible industry accepted sources to support and advance coding and documentation education and issues.
+ Extract and analyze complex data from various systems and turn into meaningful action based information for end users. Uses credible data to drive decisions.
PHYSICAL AND SENSORY REQUIREMENTS:
Sitting for up to eight hours per day. Driving distances up to 50 miles one way. Must possess hearing, seeing, speaking and reasoning senses necessary to carry out job duties. Occasional lifting/carrying of objects such as office supplies, files, etc. with maximum of ten pounds. Walking, bending, twisting and reaching necessary to carry out duties of job.
MINIMUM QUALIFICATIONS
Active Certification of CPC, CCS-P required with working knowledge of ICD-10, CPT, and HCPCS coding.
5+ years of healthcare experience with exposure to pro fee coding and compliance
Advanced Degree strongly preferred but will consider quality experience
Clinical Credentials welcome but not required
Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!!
St. Luke's University Health Network is an Equal Opportunity Employer. (http://www.slhn.org/EOE)
About the Company
S
St. Luke's University Health Network
St. Luke's University Health Network is a regional network of hospitals, physicians and other related organizations providing care primarily in Lehigh, Northampton, Monroe, Carbon, Schuylkill, Bucks, Montgomery and Berks counties in Pennsylvania and Warren County in New Jersey.
The Network provides services at more than 150 sites. St. Luke's University Health Network is comprised of six hospital sites. The Network includes:
- More than 80 owned physician-practice sites
- 300 employed primary care/specialist physicians
- Various outpatient testing and service facilities
- Home health
- Hospice services (inpatient and outpatient)
- Largest ambulance provider in Bucks County and second largest in Lehigh County
- Other related organizations
- 57,500+ annual admissions
- 195,000 annual emergency room visits
- 1,325 physicians on the Medical Staff (96 percent board-certified)
- 8,600+ employees
- More than 1,350 volunteers
Areas of exceptional medical expertise include:
- Level 1 Adult Trauma Center: fully accredited by Pennsylvania Trauma Systems Foundation; 2,400+ annual trauma cases; St. Luke's 1.75 percent mortality rate represents top decile performance, significantly better than peer group as measured by National Trauma Data Bank of the American College of Surgeons; aeromedical transport services
- Oncology: first and only cancer program in Pennsylvania to receive American College of Surgeons' highest quality recognition for three consecutive years; only Pennsylvania program to receive award in 2010; region's only fellowship-trained surgical oncologists; advanced programs for melanoma (internationally recognized melanoma investigator), lung, breast, prostate, gynecologic and gastrointestinal cancers and tumors of the brain and spine
- Cardiology and Cardiovascular Surgery: multiple-year recipient of highest rating for cardiac bypass surgery, represents top decile performance achieved by only 10 percent of U.S. hospitals (Society for Thoracic Surgery); region's first Joint Commission certified Heart Failure Program; comprehensive surgical services excluding heart transplants
- Neuroscience: accredited Stroke Center; additional Centers of Excellence include: Balance Center, Headache Center, Memory Disorders Center, Multiple Sclerosis Center, Sleep Disorders Center
- Orthopaedics: advanced expertise in total joint replacement and reconstruction, computer-assisted minimally invasive surgery, primary and reconstructive surgery of the spine, sports injuries, diseases and conditions of the hand and elbow, traumatic injuries
- Women's/Children's Health: high-risk pregnancy; the region’s busiest obstetrical service; two neonatal intensive care units; pediatric specialty care provided by St. Christopher's Hospital for Children.
- Robotic/Minimally Invasive Surgery: one of the nation's most experienced robotic surgical teams
- Radiology: designated international General Electric Healthcare Show Site for imaging technology; designated Breast Imaging Center of Excellence by American College of Radiology
- Bariatric Surgery: designated Center of Excellence by American Society for Metabolic and Bariatric Surgery and Surgical Review Corporation
St. Luke's offers an exceptional benefit plan for employees. Our values are reflected in all we do for patients, each other and the community:
Pride - We take pride in our accomplishments and in our organization.
Caring - We show consideration for others and their feelings. We treat others as we want to be treated.
Respect - We recognize the value, diversity and importance of each other, those we serve and the organization.
Accountability - We are responsible to make decisions and solve problems in a timely and effective manner.
Flexibility - We adapt to the changing needs and expectations of those we serve.
Teamwork - We work together to improve quality.
The mission of St. Luke's University Health Network is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.
COMPANY SIZE
5,000 to 9,999 employeesINDUSTRY
Healthcare Services