The Coding Trainer/QA Coordinator is responsible for developing, maintaining and presenting effective skills training, technical instruction, and educational materials for coding staff members in the Coding & Charge Capture Department. This position is also responsible for conducting quarterly quality assurance audits of UWP pro fee coders, or coordinating external audits for specific specialty areas, in accordance with the UWP Quality Assurance plan.
Specific skills training and technical instruction may include proper handling of CPT and ICD-9/ICD-10 codes; effective and efficient resolution of coding denials; efficient utilization of Epic Professional Resolute, In Basket and EpicCare modules (the ambulatory electronic medical record, or EMR), Cerner, (the inpatient EMR, also known as “ORCA”), and allied products in support of billing (such as Ingenix Claims Manager), and vendor websites.
This position requires the ability to develop and maintain Departmental coding policies and procedures, as well as the educational materials to train staff on those policies and procedures and the tools that are necessary in the performance of their jobs.
- Associate’s degree required; Bachelor's degree preferred. Experience in lieu of degree may be considered.
- Two (2) years of experience preparing and presenting training materials to individuals and staff groups of various sizes. Completion of certified training curriculum may be considered in lieu of experience.
- Three (3) years of experience with physician coding in a complex multi-specialty environment.
- Experience in an academic healthcare environment preferred.
- Coding certification (CPC, CCS-P, RHIT, RHIA etc.) required.
Knowledge, Skills & Abilities:
- Knowledge of professional billing processes
- Experience developing and providing training to individuals and groups of various sizes.
- Ability to complete detail-oriented work in a timely manner.
- Ability to maintain confidentiality and handle sensitive information with solid judgment and discretion.
- Ability to prioritize workload and meet quality and production standards.
- Ability to work well with a variety of people and be a team player.
- Excellent oral and written communication skills, with the ability to convey a positive and professional image, and to interact effectively with diverse personalities and backgrounds.
- Excellent typing/keyboarding skills with a high degree of accuracy to input data, process information and extract information in various report and presentation formats.
- Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
- Strong customer service and relationship management skills.
- Working knowledge of CMS and AMA professional coding rules and guidelines.
- Proficiency with Windows based software and Microsoft Office Suite products in a network environment.
- Knowledge of Epic EMR and professional billing system required.
- Provide training in conjunction with new Employee Orientation process.
- Facilitate online HIPAA course and Compliance training.
- Red Flag and Information Security training as required by UW Medicine policy.
- Coordinate and participate in Epic training with UWP Epic Certified Trainer.
- Conduct training on CPT and ICD-9/ICD-10 coding, charge review work queue (CRWQ) edit clearance process, insurance coding denial follow-up, customer service, UWP policies and procedures, and related computer systems.
- Provide training on coding and charge capture billing processes, customer service, insurance follow-up and UWP coding policies and procedures.
- Provide additional training and instruction on the use of UWP computer systems and EPIC billing applications.
- Ensure trainees understand and are able to use and employ the instructed procedures and work flows.
- Maintain, develop, and update training materials, as needed.
- Develop and coordinate training based on QA review outcomes.
- Work with management on service and process improvements.
- Works with the Coding & Charge Capture Leadership Team to improve the accuracy, integrity and quality of coding, to ensure minimal variation in coding practices.
- Works with the Coding & Charge Capture Leadership Team to provide coder specific education and global coding education based on the quality monitoring review findings and trends.
- Assist in the development and implementation of new or revised policies, procedures and work flows within the Coding & Charge Capture Department.
- Assist in development and maintenance of Quality Assurance programs:
- Conduct routine internal quality assessment reviews in accordance with UWP’s Quality Assurance Program requirements and utilize extensive regulatory coding (ICD-9-CM, CPT-4, and ICD-10-CM) and reimbursement knowledge to ensure compliance with national coding guidelines and coding policies in a multi-specialty environment, or coordinate with external vendors, as directed.
- Document and deliver audit results to Coding & Charge Capture leadership.
- Fully comprehend the requirements of UWP’s Quality Assurance program and interpret standard procedures and policies in applying them in the QA review tasks.
- Prepare and present coding compliance status report to the Coding & Charge Capture Leadership Team
- Assist in identifying accounts for coding quality reviews
- Perform other duties, as assigned.