Job location: Miami, FL

Employment Type: Full-time
Posted data: 2019-04-15
Req: R100031382
Current Employees:
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Where Excellence Meets Purpose

The University of Miami is among the top research universities and academic medical centers in the nation, and one of the largest private employers in South Florida.

With more than 16,000 faculty and staff, the University strives for excellence, and is driven by a powerful purpose to transform and impact the lives of its students, patients, members of the community, and people across the globe.

The University is committed to fostering a culture of belonging, where everyone feels valued and has the opportunity to add value.  Through values of Diversity, Integrity, Responsibility, Excellence, Compassion, Creativity, and Teamwork (DIRECCT) the U community works together to create an environment driven by purpose, excellence, community, and service.

The University has been named on Forbes's Best Employers list for two consecutive years, and is the only university in Florida to receive this honor.

The Coding Educator plans and performs coding reviews to monitor coders' performance on regular and continuous bases. The Coding Educator serves as knowledge expert of coding guidelines while identifying trends, educational opportunities and assisting with training. The incumbent provides strategic advice and recommendations with regards to policies, rules and regulations. Additionally, the incumbent ensures policies and procedures are continuously monitored, evaluated and is responsible for executing, maintaining and conducting quality reviews.

CORE JOB FUNCTIONS                                                                                                          

Analyzes and reviews medical documentation for appropriateness and completeness and ensures application of all appropriate procedural codes, diagnosis codes and modifiers to all fee services. Reviews medical records for adherence to all Teaching Physician Guidelines and other applicable Federal, State and third party regulations Prepares reports of findings and meets with coder and providers to provide education and training on accurate coding practices and compliance issues. Provides second-level review of billing performances to ensure compliance with legal and procedural policies and to ensure optimal reimbursements while adhering to regulations prohibiting unbundling and other questionable practices. Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, denials, and billable services. Interacts with physicians and other patient care providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation. Assists with the development, oversight, and monitoring of compliance programs within the designated area. Verifies that regulatory policies and procedures are being properly documented, implemented, and communicated throughout the designated area. Identifies compliance issues that require follow-up or investigation. Designs and implements improvements in communication, monitoring, or enforcement of compliance standards. Develops and conducts training in relation to compliance standards. Maintains and distribute information regarding trends and best practices. Assesses the potential impact of these changes on organizational processes. Performs other duties and responsibilities as assigned by supervisor. Responsible for assigning and monitoring coding education through our learning management system Adheres to University and unit-level policies and procedures and safeguards University assets.

CORE QUALIFICATIONS                                                                                                         

Bachelor’s degree in relevant field required.Coding Certification

Experience:

Minimum 5 years of experience required

Knowledge, Skills and Attitudes:

• Ability to work independently and/or in a collaborative environment.
• Ability to exercise sound judgment in making critical decisions.
• Ability to lead, motivate, develop and train others.
• Ability to communicate effectively in both oral and written form.
• Ability to maintain effective interpersonal relationships.

The University of Miami is an Equal Opportunity Employer - Females/Minorities/Protected Veterans/Individuals with Disabilities are encouraged to apply. Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Click here for additional information.

Job Status:

Full time

Employee Type:

Staff

Pay Grade:

c109