Regular Full Time
Pay Range: 77350.00-95000.00
   

Responsibilities:
The Sr. Medical Review Training Specialist (Outpatient Coding), partners with applicable operational business leaders, including functions such as compliance, appeals, and quality, and is responsible for the development, delivery, and continuous improvement of operational training program and tools for the line of business that contributes to increasing staff capability and its overall success.  This position requires strong subject matter expertise, experience developing and delivering training content via a variety of methods and tools effective for remote workforce, excellent interpersonal and communication skills, and demonstrated ability to have meaningful impact on operational workforce capability through training programs and tools.  

Employ a variety of methods to maintain current in-depth knowledge, requirements, and subject matter expertise for business segment (legal, regulatory, compliance, and client requirements) in a dynamic environment.
Develop structured training program and material for policies & procedures and comprehensive review guidelines for audit, operations support, and other audit-related staff, with a specific emphasis on medical coding.
Maintaining the calendar of assigned training and ensuring that training is scheduled and delivered based upon internally developed timelines, legal, and contractual requirements, as applicable.
Plan, coordinate, deliver, track, monitor, and report new hire training, as well as ongoing training as required for periodic refreshers, performance improvement, new or modified operating procedures, workflows, tools, requirements, etc.
Monitors coordination in HR communication and Training Specialist in onboarding, access coordination, and scheduling.
Employ a variety of methods to gather information and input to assess training gaps and programs effectiveness such as 360-degree feedback (from trainees, management, and applicable stakeholders), operational performance and QA results, appeals and other metrics at individual and group level, as well as from audit performance, QA results, Appeal metrics and other inputs.
Analyzes the methods and resource tools to identify changes to the current training plans bases on the feedback obtained and assist in the development and restructure of the plan.
Provide instruction and direction to employees on proper usage of on-line training tools and provides follow-up to ensure staff completion of required assigned training in a timely manner, leveraging support from employees management and/or HR if required.
Assist the Training Specialist in providing valuable resources or tools for guidance of delivering training materials to the employees using their full potential as well as role development.
Apply outcomes of program assessment and needs inputs toward continuous improvement and further development of training program scope, courses, materials, and tools.
Analyzes outcomes of program assessment and maintains records and tracking for management.
Utilize effective adult learning training pedagogy to maximize successful knowledge transfer and skill building, as well as tools and methods for efficiency in training records management effectively in remote/virtual classroom, as well as in-office training.
Research current pedagogy effectiveness and processes for improvement opportunities based on current outcomes.
Conduct effective training 1:1 and various group size settings.
Observes Training Specialist training sessions and provides peer review feedback on a routine basis while including documentation of feedback to Manager.  
Serve as a subject matter expert regarding official coding guidelines, audit system functionality and audit workflows and files. Knowledge of payer reimbursement methodologies is a plus.
Will research and partner with the subject matter experts to provide yearly coding updates and prep education materials related to those updates.
Provide training on Audit guidelines, to ensure compliance with client requirements and in conformance with proper medical coding techniques.
Will collaborate with leadership including scheduling meetings with managers of all areas to compare expectations and utilize tracking tools to ensure compliance and updated training is being provided to their staff.
Deliver concept-based training which may include reviewing operative reports and other documentation to properly code services using current CPT, HCPCS and ICD 10 CM/PCS codes.
Serves as support to coding staff when Training Specialist are unavailable.
Proactively monitor changes to coding/clinical methodologies, official guidelines, regulatory standards, and update training material for delivery to auditors using relevant training methods.
Monitor progress and need for updates on Education Library and communication platforms such as Confluence and Jira.
Support Medical Review management in documenting workflows and process improvement plans as needed.
Manages engagement of leadership and Training Specialist when management is unavailable.
Provide consultative input to the development of business requirements for audit platform and reporting enhancements to prepare for User Acceptance testing and development of relevant training materials; deliver training on new client implementation, new audit programs, new audit products and/or new audit concepts.
Conduct User Acceptance Testing on new workflow platform and/or reporting enhancements, ensuring correct functionality, documenting all changes and incorporating changes into training materials and training plans as required.
Leads by example.
Promote the roles of the Training Specialist in a positive and professional manner internally and externally. 
Collaborates and provides assistance for special projects, as assigned.


*Note - All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times.  Violations to Performants policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination.

 

 

Required Skills and Knowledge:

Strong operational subject matter expertise medical outpatient coding techniques.
Must have exposure and experience with health care technology (Electronic Medical Records, Coding software and Practice Management Information Systems).
Knowledge of laws, regulations, or policies impacting the Healthcare industry and understanding of Managed Care requirements under the Medicare/Medicaid and other third-party payor programs.  
Demonstrated ability to take complex ideas and large amounts of information and distill to key learning concepts and principals appropriate for audience intended learning and development.
Ability to rapidly comprehend and teach new information.
Demonstrated strength facilitating/presenting information to various audiences in a professional manner with high success in knowledge transfer and skill enhancement. 
Ability to implement concepts of adult learning principles, instructional design, needs assessment and performance measurement and evaluation.
Demonstrated Project/program management skills.
Good research and problem-solving skills.
Demonstrated technical competence to quickly learn and leverage various applications and tools.
Intermediate to advanced skills in Word, Excel, PowerPoint, and curriculum development tools. Experience developing and delivering learning materials through a Learning Management System (LMS) highly desired.
Demonstrated ability to develop high quality training plans, courses, and content, with effective delivery and assessment methods. 
Must have ability to work with sensitive information and maintain confidentiality.  
Builds credibility and trust. 
Mind-set of continuous improvement and adapts quickly to change.
Excellent written and verbal communication, and interpersonal skills.
Ability to effectively interact with all levels internal and external to the organization. 
Demonstrates ability to apply good judgment.
Can work independently as well as effectively collaborate within a team and cross-functionally.
Self-motivated and ability to drive results given direction in the form of objectives.
Demonstrates good judgement in decision making. 
Possess excellent analytical skills and strong attention to detail. 
Efficient organization and effective time management.
Additional Requirements:

Ability to obtain and maintain client required clearances as well as pass company regular background and/or drug screening.

Completion of Teleworker Agreement upon hire, and adherence to the Agreement (and related policies and procedures) including, but not limited to: able to navigate computer and phone systems as a user to work remote independently using on-line resources, must have high-speed internet connectivity, appropriate workspace able to be compliant with HIPAA, safety & ergonomics, confidentiality, and dedicated work focus without distractions during work hours.

Physical Requirements:

**NOTE: Must be able to meet requirements for and perform work assignments in accordance with Company policies and expectations on a home remote basis (and must meet Performant remote-worker requirements) until at which time staff may be notified and required to work from a Performant office location on an ad-hoc or periodic basis.

Basic office equipment required to perform remote work is provided by the company.

Job is performed in a standard busy office environment with moderate noise level (or may be home-office setting subject to Company approval and Teleworker Agreement), sits at a desk during scheduled shift, uses office phone or headset provided by the Company for calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a mouse.
Reads and comprehends information in electronic (computer) or paper form (written/printed). 
Sit/stand 8 or more hours per day; has the option to stand as needed while on calls; reach as needed to use office equipment.
Consistently viewing a computer screen and types frequently, but not constantly, using a keyboard to update accounts.
Consistently communicates on the phone as required primarily within the department and company and may include client contacts or other third-party depending on assignment with account holders, may dial manually when need or use dialer system; headset is also provided.
Occasionally lift/carry/push/pull up to 10lbs.
Travel as required to meet business needs.

 

Education and Experience:
Associate degree in relevant field, or equivalent (additional 4 years of directly applicable experience), Bachelors degree preferred.
Current Active Coding Certification from AHIMA or AAPC: CPC, CPC-H, CPC-P, RHIA, RHIT, CCS, or CCS-P
Active Registered Nursing license highly preferred.
5 years or more directly relevant professional level outpatient facility coding experience, such as: ICD-9, ICD-10, CPT-4 or HCPCS.
Prior experience in similar role or function with responsibility for developing and delivering effective knowledge and skill development programs; delivery of remote learning is highly preferred.
Prior staff and/or program management experience in healthcare service delivery highly desired.
 


Other Requirements:

Performant is a Government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and clearances (as applicable).
Must submit to and pass pre-hire background check, as well as additional checks throughout employment.
Must be able to pass a criminal background check; must not have any felony convictions or specific misdemeanors, nor on state/federal debarment or exclusion lists.
Must submit to and pass drug screen pre-employment (and throughout employment).
Performant is a government contractor. Certain client assignments for this position requires submission to and successful outcome of additional background and/or clearances throughout employment with the Company.

Applicants must have reliable, secure, high speed Internet access at their home office location.


  
Employment VISA Sponsorship is not available for this position

Job Profile is subject to change at any time.

EEO 
Performant Financial Corporation is an Equal Opportunity Employer. 
Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. 

NO AGENCY SUBMISSIONS WITHOUT PERFORMANT AUTHORIZED AGENCY AGREEMENT AND APPROVED PERFORMANT JOB ORDER

 

   


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