Patient Navigator - Registered Nurse in Amherst, New York at UBMD Internal Medicine

Company Description

UBMD Internal Medicine (UBMDIM) is the academic medical practice associated with the University at Buffalo's Jacobs School of Medicine and Biomedical Sciences. With 135 primary and specialty care physicians and 187 staff members, UBMDIM operates across 16 hospital and outpatient clinic locations. It is the largest practice plan within UBMD Physicians' Group, providing patient care, educating future medical professionals, and conducting groundbreaking research to advance healthcare in the Buffalo area.

Role Description

This is a full-time on-site role located within the Buffalo for a Coding Educator and Auditor. The role focuses on planning and delivering education sessions related to medical coding, conducting audits for accuracy and compliance, and ensuring best practices in medical documentation for billing and coding specialists, physicians, and other healthcare professionals. The position will involve collaborating with healthcare professionals, implementing training programs, and maintaining compliance with regulatory and organizational policies.

Essential Functions:

Lead training sessions on current billing and coding information to ensure staff is up-to-date on industry standards.
Develop and design presentations and training materials, such as handbooks and resources to support learning.
Perform quality assurance reviews to assess comprehension of training efforts.
Organize and participate in coding and reimbursement meetings to address updates, challenges, and improvements.
Research and analyze updates in coding regulations, ensuring timely communication of changes to physicians and billing staff.
Respond to coding inquiries and provide expert guidance to billing specialists and clinicians.
Conduct coding audits and chart reviews to verify accurate coding of billed services and compliance with regulations.
Provide ongoing education and updates on payer policies, ICD-10, CPT, and other relevant coding standards.
Collaborate with EHR systems personnel and hospital/clinic staff to ensure efficient and accurate billing.
Work closely with providers, billing teams, and administrative staff to ensure all services, procedures, and tests are accurately documented and coded in the EMR system.
Assist internal and external auditors by providing necessary support and documentation.
Develop and utilize reports and metrics to monitor departmental performance and assist with organizational goals.
Update billing workflows, SOP’s, and guidelines in collaboration with the DRCA.
Monitor and ensure compliance with company policies, state and federal regulations, and HIPAA requirements.
Educate providers on coding and billing compliance, ensuring they remain informed of payer regulations and internal policies.
Perform daily billing and auditing tasks to ensure compliance and resolve coding issues.
Conduct comprehensive audits to assess the integrity of coding and billing practices, identifying and addressing documentation errors.
Provide detailed audit feedback to providers, offering guidance and education based on audit results.
Lead educational sessions to address audit findings and promote compliance across the organization.
Serve as a subject matter expert on coding compliance, establishing positive working relationships and providing risk input.
Support other coding and audit initiatives as needed by the executive leadership team.
Other Functions:

Collaborate with the billing department to maximize billing efficiency and revenue.
Work with the billing team to identify and address coding errors and missed revenue opportunities, as applicable.
Check company email daily to promptly address notifications and other important communications.
Perform additional duties as requested by the Director of Revenue Cycle Administration (DRCA), Chief Operating Officer, or other management representatives.
Travel to other UBMDIM locations as needed based on company requirements.
Qualifications:

Education: Associate’s degree required; Bachelor’s degree preferred.
CPC (Certified Professional Coder) certification required.
Strong expertise in Lesson Planning, Teaching, and Training
Proficiency in Education and Communication to effectively convey knowledge and feedback
Experience conducting audits and evaluating coding accuracy
Understanding of medical coding standards and compliance regulations
Strong attention to detail and organizational skills
Experience in the healthcare industry and relevant certification in coding/auditing is preferred
Experience:

Minimum of 4-5 years of experience in medical billing or coding required.
Job Type: Full-time

Benefits:
401(k)
401(k) matching
Dental insurance
Employee assistance program
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid time off
Retirement plan
Vision insurance
Work Location: In person