Outpatient Coding Quality Education Specialist

Job Description

Lakeland Regional Health is a leading medical center located in Central Florida. With a legacy spanning over a century, we have been dedicated to serving our community with excellence in healthcare. As the only Level 2 Trauma center for Polk, Highlands, and Hardee counties, and the second busiest Emergency Department in the US, we are committed to providing high-quality care to our diverse patient population. Our facility is licensed for 910 beds and handles over 200,000 emergency room visits annually, along with 49,000 inpatient admissions, 21,000 surgical cases, 4,000 births, and 101,000 outpatient visits.

Lakeland Regional Health is currently seeking motivated individuals to join our team in various entry-level positions. Whether you're starting your career in healthcare or seeking new opportunities to make a difference, we have roles available across our primary and specialty clinics, urgent care centers, and upcoming standalone Emergency Department. With over 7,000 employees, Lakeland Regional Health offers a supportive work environment where you can thrive and grow professionally.

Work Hours per Biweekly Pay Period : 80.00

Shift : Monday - Friday

Location : 210 South Florida Avenue Lakeland, FL

Pay Rate : Min $63,793.60 Mid $79,747.20

Position Summary

Under the direction of the facility Coding and Reimbursement Manager, conducts coding quality reviews and audits of chart documentation to assess accuracy, ensure compliance with federal and payer policies, and identifies areas for improvement for hospital outpatient coding. Develops and delivers training on coding accuracy and compliance, staying updated on regulations and providing expert guidance to coders. Provides ongoing coding education and training to coding team and serves as mentor to all new coding team members. Serves as a subject matter expert and resource for coders, providers, and other staff on coding questions, regulatory changes, and best practice. Prepares reports of findings and meets with coders and Coding Leadership to provide education and training on accurate coding practices and compliance issues.

Has thorough knowledge of acute care facility guidelines, modifiers, sequencing rules and the NCCI (National Correct Coding Initiative) edits, OCE (Outpatient Code Editor) edits, Official Guidelines for Coding and reporting for ICD-10-CM / PCS, CPT-4, and HCPCS coding conventions, APC payment classifications and Medicare Conditions of Participation. Will assist the Coding and Reimbursement Manager on preparing presentations and / or interdepartmental feedback.

Responsible for conducting coding and billing training programs for billing and coding specialists. Other duties will include implementing coding department policies and procedures and assisting with reviewing and appealing coding denials.

People At The Heart Of All That We Do

• Fosters an inclusive and engaged environment through teamwork and collaboration.
• Ensures patients and families have the best possible experiences across the continuum of care.
• Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created.

Safety And Performance Improvement

Stewardship

People At The Heart Of All We Do

Competencies & Skills

Essential :

Qualifications & Experience

Essential :

Essential :

Other information :

Experience essential :

5+ years acute care hospital outpatient coding experience and / or coding auditing

5-10 years of educational experience in a facility or consulting setting.

Certification essential :

CCS, CPC, RHIT, or RHIA

Certification preferred :

RHIA