Centra Health

The Professional Coding & Audit Specialist I performs audits of provider documentation and coding of professional evaluation & management services. This position also provides education and training to providers and staff related to professional coding and documentation. | The job requires knowledge of current coding guidelines, regulatory requirements, and billing rules. Experience in auditing and coding for E/M services is essential. | The Professional Coding & Audit Specialist I performs audits of Centra Medical Group (CMG) provider documentation and coding of professional evaluation & management (E/M) services to include E/M, International Statistical Classification of Diseases and Related Health Problems, tenth version- Clinical Modification (ICD-10-CM), Current Procedural Terminology (CPT) codes and modifiers to determine accuracy based on current coding guidelines, regulatory requirements and billing rules related to coding. This position provides education and training to CMG providers and staff related to professional coding and documentation under the direction of the Manager Professional Coding & Audit and the Professional Coding and Audit Specialist.

Design and lead training programs for revenue cycle staff, observe workflows, and provide real-time feedback to ensure accurate revenue cycle processes. | Experience in revenue cycle functions, training development, staff coordination, and ability to provide on-demand direction. | The Lead Revenue Cycle Educator designs, organizes, and directs training programs for centralized revenue cycle staff as well as staff performing revenue cycle functions within the organization. This role is a key change component to ensure accurate registration, claim creation, and claim submission processes are followed to support the collection of revenue from payers and patients. The Lead Revenue Cycle Educator creates training guides and virtual training sessions to assist caregivers in performing their assigned tasks. The educator coordinates and conducts observation of workflow, providing real time feedback, andon demand direction.

Assist in implementing and maintaining GRC programs, conduct risk assessments and audits, develop policies and procedures, and collaborate with departments to ensure compliance. | Experience in governance, risk management, compliance programs, policy development, risk assessments, audits, and strong collaboration and documentation skills. | The Governance, Risk, and Compliance (GRC) Specialist role is responsible for assisting in the implementation and maintenance of the organization's governance, risk management, and compliance (GRC) programs. This includes supporting the development of policies and procedures, conducting basic risk assessments and audits, and helping to ensure that the organization is compliant with relevant laws, regulations, and standards. This role often involves collaborating with other departments to gather and analyze compliance data, as well as contributing to the preparation of reports and documentation related to GRC activities.