Job Description

Job Title:                      Provider Coding Trainer

Reports To:                   Revenue Cycle Manager

Job Summary:                   Reviews and ensures accuracy of medical coding for all services rendered by providers.


Qualifications and Requirements:

To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  This job description in no way implies that these are the only duties to be performed and may be modified, interpreted and/or applied in any way, as necessary.  Maintaining regular and punctual attendance is required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.


Essential Job Duties:

Provider and Staff Training

  • Obtain and maintain proficiency with Nextgen EHR best practices for the purpose of training providers.
    • Familiarize him/herself with and understand the sequences of codes needed to optimize audits associated with quality measures and train providers in accurate, up to date coding, including review of coding and documentation associated with value-based contracts.
    • Collaborate in the development of workflow with regards to quality measures associated with Value Based Contracts, Uniform Data System, and other agencies as applicable.
    • Works directly under the supervision and reports to the physician coder and/or Revenue Cycle Director to develop coding education.
    • Works concurrently as a team with Revenue Cycle Billing to ensure smooth coding and documentation and accurate submission of claims from the coding and documentation perspective,
    • Identity training opportunities that will positively impact staff efficiency, revenue cycle and/or success in quality measures.
    • Provides education, when requested, regarding present and future coding guidelines based on industry trends and best practices.
    • Attend trainings and meetings, internal and external, as applicable, as well as meets regularly with the physician coder.

Conduct Coding Audits

  • Conduct routine audits, as directed by physician coder, using patient medical charts for appropriate coding compliance.
  • Maintain proficiency in best practice guidelines for FQHC coding and billing and shares this knowledge with teams involved.
  • Assign and sequence appropriate diagnostic/procedure billing codes as applicable, in compliance with third party payer requirements and provides input, training and information that allows coding rules to be in place in Nextgen, quality measures teams and Revenue Cycle.
  • Based on audit findings, provide appropriate and targeted training and education in collaboration with the physician coder to providers and clinical support staff.
  • Assist in establishing coding productivity and quality goals with the physician coder.
  • Complete special coding and billing projects as assigned by the physician coder.


Assist Revenue Cycle with Coding Questions

Act as a liaison between Physician Coder, Providers, Nurse Managers, otter coders and Revenue Cycle personnel.

            Collaborate with Revenue Cycle Department to help ensure proper codes are submitted to claims.

            Be available to answer questions regarding claims denial attributed to coding.

            Understand and compile data concerning local patterns of codes that payers require for timely payment,

Required Education, Experience, Certificates & Licenses:

  • Associates degree or higher required. Any combination of experience and/or education that provides the necessary skills will be considered.
  • Certified Professional Coder (CPC) or Certified Coding Specialist-Physician (CCS-P) required.
  • One-year experience in FQHC medical billing preferred.
  • In addition, two or more years with coding experience in a large health care organization is preferred.
  • Ability to work in a team and demonstrated experience with training personnel in coding is required.
  • Participates in training and education programs to maintain professional competence and skills.
  • Valid Fingerprint Clearance Card.


Required Language Skills:

  • Ability to comprehend and compose effective instructions, correspondence, and communications in English in both oral and written format.


Physical Requirements:

  • Ability to occasionally exert enough force to move objects weighing up to 10 pounds.
  • Ability to continuously remain in a stationary position.
  • Ability to occasionally move about inside the workplace to access files, office machinery, etc.
  • Possesses hand-eye coordination and manual dexterity necessary to constantly operate computer, telephone, and other office machinery.
  • Possesses close visual acuity necessary to accurately record and view information on a computer monitor, handwritten and typed documents.
  • Ability to discern the nature of sounds at a normal spoken volume.


Other Required Knowledge, Skills, and Abilities:

  • Ability to add, subtract, multiply and divide in all measure, using whole numbers, common fractions, and decimals.
  • Ability to compute rate, ratio, and percent.
  • Ability to skillfully gather and analyze data.
  • Ability to perform variety of assignments requiring independent judgment.
  • Ability to deal with challenges involving one or more variables in routine situations.
  • Knowledge of billing, medical records, health plans, and community health centers preferred.
  • Advanced, specialized knowledge of medical codes and coding procedures.
  • Thorough knowledge of ICD, CPT, and NDC codes.
  • Knowledge of HIPAA and Corporate Compliance rules and regulations.
  • Computer literacy required in Microsoft Office.
  • Proficiency in Nextgen EHR software preferred.


Work Environment & Conditions:

  • Work environment is usually typical of an administrative office setting with no substantial exposure to adverse environmental conditions.