Job Posting: The Clinical Education Specialist - (HCC) is responsible for reviewing chart notes for proper code assignment with an emphasis on provider education, documentation and coding improvement, and revenue capture. The CES provides education to clinicians, clinic staff, and others as needed via face-to-face meetings, classroom settings and webinars. The CES also develops, maintains and presents coding and compliance educational materials to staff and clinicians. In addition, the CES collaborates with the Manager of Physician Coding Education to support the needs of PBS where coding expertise/education is needed. This position is also responsible for analysis and assessment of governmental and non-governmental payer audits, conducts focused reviews and monitors provider compliance with medical record documentation after training and education. ESSENTIAL JOB DUTIES:
Acts as documentation and coding liaison to clinicians to include review, education and necessary follow-up to help ensure that clinical documentation and coding services meet government and organizational policies and procedures.
Analyzes and provides education on revenue capture, clinical documentation including Electronic Health Record (EHR) requirements, coding accuracy and denial management to clinicians and clinic staff.
Assists in determining educational needs based on documentation reviews, provider/staff feedback, data analysis (bell curves).
Reviews documentation and coding for new providers for accuracy and charge capture as per standard.
Responsible for sending coding reports to providers received from coding vendor resources
Communicates directly with providers on coding feedback and chart review findings
Prepares necessary reports and communicates results of audits to management, clinicians, and committees as appropriate.
Reports areas of risk directly to the Manager – Physician Coding Education.
Maintains a high level of competency related to clinical documentation and coding in assigned specialty and other areas and compliance with government regulations by attending appropriate workshops and seminars.
Monitors Medicare and other Payer rules for updates and changes.
Uses spreadsheets to log physician performance results and to re-educate on those outstanding issues and trends.
Maintains familiarity with such issues as HCFA E/M Documentation Guidelines, HCFA Teaching Physician Documentation Guidelines and the OIG model compliance plans.
Attends seminars and workshops, as applicable, for updates on new coding rules and regulations.
Participates in decision making concerning departmental policies and procedures
Meets organizations objectives set by leadership.
Understands coding trends by billing area, location, and provider for all groups and physicians.
Handles in a professional and confidential manner all correspondence, documentation, and files.
Supports CSMN's core values, policies, and procedures.
Follows policies and procedures pertinent to the coding and compliance departments. #LI-SR1 GD-MDN
Providing healthcare for more than 100 years, Cedars-Sinai has evolved into one of the most dynamic and highly renowned medical centers in the world. Along with caring for patients, Cedars-Sinai is a hub for biomedical research and a training center for future physicians and other healthcare professionals. This attracts exceptional talent to Cedars-Sinai, including world-renowned physician-scien...tists who seek a place where they can both conduct research and see patients--the ideal formula for discovery and its translation into cures. Our patients benefit from access to doctors at the top of their fields, and our researchers have an ideal community in which to study the impact of healthcare challenges, and reflect that knowledge in their research. The greater Los Angeles area in which Cedars-Sinai resides possesses unparalleled cultural and ethnic diversity which offers outstanding opportunities for translational and clinical research and a dynamic environment for medical education.Although community based, Cedars-Sinai is a major teaching hospital affiliated with the David Geffen School of Medicine at the University of California, Los Angeles (UCLA). Cedars-Sinai has highly competitive graduate medical education programs in more than 50 specialty and subspecialty areas, a graduate program in biomedical sciences and translational medicine, a clinical scholars program directed towards junior physicians with aspirations to become clinical scientists, and post graduate training opportunities.There are more than 250 full-time faculty members at Cedars-Sinai. The voluntary medical staff, comprised of more than 2,200 specialty board-certified or board-qualified physicians, represent all of the specialties and subspecialties and collaborate with full-time medical staff in the teaching responsibilities of the graduate medical education programs.