Work where every moment mattersEvery day over Hartford HealthCare colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare networkThe creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole rather than a single member organizationWith the creation of our new umbrella organization we now have our own identity with a unique payroll benefits performance management system service recognition programs and other common practices across the systemPosition SummaryThe Audit Education Specialist develops and implements an effective and comprehensive audit education program for coding consistent with regulatory contractual professional standards and healthcare revenue cycle industry practices The audit and education specialist will support documentation practices that comply with CMS risk adjustment program requirements and ICD coding guidelines Reporting to Manager of Audit and EducationPosition ResponsibilitiesKey Areas of Responsibility Performs revenue opportunity assessment and executes the professional audit work plan which includes provider audit and education with QA Compile and prepares complex reports for distribution to key leadership stakeholders Analyzes audit results creates material for education and performs education and training for providers and staff to ensure updates and quality assurance on coding Creates and trains on documentation templates designed for specialtyclient eg medical reports monitoringanalysis reports continuous auditing tools etc to insure appropriate documentation is captured for services rendered Researches literature from regulatory groups such as HHSOIG Medicare Medicaid NGS etc professional and peer organizations practicespoliciesguidelines to keep organization current with regulatory requirements and accepted audit and education practices Identifyrsquos common documentation and coding issues and process improvement and effectively communicates via memos and other documentation to disseminate audit requirements Identify process improvements to capture data for Medicare Risk Adjustment and help providers code to the level of specification Builds relationships programs and processes alongside providers that will result in more accurate documentation and coding of diagnoses Develops strategies to support knowledge transfer and testing to determine outcome and success of training Provides individualized education to physicians and tracks performance over time Demonstrate a face to face communication style and address issues as they ariseWorking RelationshipsThis Job Reports To Job Title Audit and Education Specialist ManagerWork where every moment mattersEvery day over Hartford HealthCare colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare networkThe creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole rather than a single member organizationWith the creation of our new umbrella organization we now have our own identity with a unique payroll benefits performance management system service recognition programs and other common practices across the systemPosition SummaryThe Audit Education Specialist develops and implements an effective and comprehensive audit education program for coding consistent with regulatory contractual professional standards and healthcare revenue cycle industry practices The audit and education specialist will support documentation practices that comply with CMS risk adjustment program requirements and ICD coding guidelines Reporting to Manager of Audit and EducationPosition ResponsibilitiesKey Areas of Responsibility Performs revenue opportunity assessment and executes the professional audit work plan which includes provider audit and education with QA Compile and prepares complex reports for distribution to key leadership stakeholders Analyzes audit results creates material for education and performs education and training for providers and staff to ensure updates and quality assurance on coding Creates and trains on documentation templates designed for specialtyclient eg medical reports monitoringanalysis reports continuous auditing tools etc to insure appropriate documentation is captured for services rendered Researches literature from regulatory groups such as HHSOIG Medicare Medicaid NGS etc professional and peer organizations practicespoliciesguidelines to keep organization current with regulatory requirements and accepted audit and education practices Identifyrsquos common documentation and coding issues and process improvement and effectively communicates via memos and other documentation to disseminate audit requirements Identify process improvements to capture data for Medicare Risk Adjustment and help providers code to the level of specification Builds relationships programs and processes alongside providers that will result in more accurate documentation and coding of diagnoses Develops strategies to support knowledge transfer and testing to determine outcome and success of training Provides individualized education to physicians and tracks performance over time Demonstrate a face to face communication style and address issues as they ariseWorking RelationshipsThis Job Reports To Job Title Audit and Education Specialist ManagerEducationmiddot Minimumo Medical Coding License required CPC CCS P CCS o Minimum of five yearsrsquo work experience with CPT HCPCS and ICD coding conventions required Experience with interpreting Medicare Medicaid and third party billing and compliance regulations necessary Experience with Claim Submission requirements requiredo Demonstrates experience analyzing data review results and providing education to both clinical providers and coders in a productive manoro Exemplary communication skills ability to navigate challenging conversations and provide effective provider training in large and small groupso Demonstrates experience in project management and follow up requiredo Progressively responsible role with leadershipmiddot Preferredo Experience working with CMS health insurers and medical providers strongly desired o CPMA not required but preferred o Baccalaureate degree not required but preferredo CRC not required but preferred it is expected that candidates that are not CRC qualified will obtain the qualification within the first months of their employment with Hartford Healthcare o Experience with the nuances of diagnosis coding and risk adjustment programs preferredo Experience working in an educational training role preferredo Experience with Word Excel and PowerPoint required Knowledge of business systems eg Epic preferredLicensure Certification Registrationmiddot Medical Coding License CPC CCS P CCSmiddot CRC preferred required within months of hireKnowledge Skills and Ability Requirementsmiddot Commitment to maintain complete confidentiality of patient health information middot Will require on site auditing and trainingmiddot Reliable transportation insurance and a valid drivers licensemiddot Must be able to excel in a fast paced business environment handling multiple priorities Must be highly effective in both written and oral communication middot Must be able to exercise appropriate judgment when making decisionsWe take great care of careersWith locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this isyour momentEducationmiddot Minimumo Medical Coding License required CPC CCS P CCS o Minimum of five yearsrsquo work experience with CPT HCPCS and ICD coding conventions required Experience with interpreting Medicare Medicaid and third party billing and compliance regulations necessary Experience with Claim Submission requirements requiredo Demonstrates experience analyzing data review results and providing education to both clinical providers and coders in a productive manoro Exemplary communication skills ability to navigate challenging conversations and provide effective provider training in large and small groupso Demonstrates experience in project management and follow up requiredo Progressively responsible role with leadershipmiddot Preferredo Experience working with CMS health insurers and medical providers strongly desired o CPMA not required but preferred o Baccalaureate degree not required but preferredo CRC not required but preferred it is expected that candidates that are not CRC qualified will obtain the qualification within the first months of their employment with Hartford Healthcare o Experience with the nuances of diagnosis coding and risk adjustment programs preferredo Experience working in an educational training role preferredo Experience with Word Excel and PowerPoint required Knowledge of business systems eg Epic preferredLicensure Certification Registrationmiddot Medical Coding License CPC CCS P CCSmiddot CRC preferred required within months of hireKnowledge Skills and Ability Requirementsmiddot Commitment to maintain complete confidentiality of patient health information middot Will require on site auditing and trainingmiddot Reliable transportation insurance and a valid drivers licensemiddot Must be able to excel in a fast paced business environment handling multiple priorities Must be highly effective in both written and oral communication middot Must be able to exercise appropriate judgment when making decisionsWe take great care of careersWith locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this isyour moment