Coding Liaison, Professional Billing Coding

JOB DETAILS
Department: Professional Billing Coding
FTE: 1.00 (80 hours per pay period)
Workdays: Monday - Friday
Shift(s): Days
Shift Length: 8 hours
Location: Remote*

*Current List of non-MN States where Hennepin Healthcare is an Eligible Employer: Alabama, Arizona, Arkansas, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Mississippi, Nevada, North Carolina, North Dakota, New Mexico, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin.
 

Purpose of this position: Provides support, education, and feedback to the Physicians, Advanced Practice Providers, Residents, and Coding Staff on documentation guidelines and billing trends

RESPONSIBILITIES

• Assists with New Provider Onboarding
• Presents education points and/or findings to Physicians, Advanced Practice Providers, Residents, and Coding Staff regarding coding and billing trends and related quality metrics
• Develops and executes departmental review projects with measurable financial and/or compliance goals per analysis findings
• Organizes, analyzes, and presents data for the purpose of supporting Department Chiefs, Practice Managers, and other stakeholders throughout the organization to outline and institute strategies for improvement
• Collaborates with other departments and key stakeholders to determine trends and educational needs
• Analyzes provider documentation and billing practices through financial and coding activity reports, as well as documentation reviews, to identify potential opportunities for revenue capture and recognize areas of compliance concern
• Performs a detailed annual review of CPT and ICD-10-CM which includes identifying codes that have been deleted, added, or replaced; identifies description changes and communicating these changes to clinical departments that will be impacted
• Supports clinical areas and departments in charge capture and coding accuracy to ensure organization-wide uniformity of charges and coding for similar products and procedures
• Identifies/investigates issues with medical necessity, coding, and billing that reduce reimbursement; recommends action steps and works collaboratively with the department to improve processes when operational weaknesses and/or compliance issues are found
• Conducts annual provider quality reviews to evaluate the appropriateness of services and procedures billed based on supporting documentation; evaluates appropriateness of diagnoses (ICD) and procedural (CPT) codes billed for services; evaluates adequacy of documentation to meet the Teaching Physician guidelines; evaluates level of service billed for evaluation and management (E/M) services, evaluates appropriateness of modifier usage
• Other duties as assigned

QUALIFICATIONS
Minimum Qualifications:

• Two (2) years post-secondary education in HIM field

-OR-

• Three (3) years external coding/reimbursement experience
• Certification/License Required: 
  • RN
  • CCS-P, CPC, RHIT, RHIA
  • CDIP, CCDS

-OR-

• An approved equivalent combination of education and experience

Preferred Qualifications:

• Bachelor’s Degree in health related field

Knowledge/ Skills/ Abilities:

• Strong interpersonal and communication skills
• Comfortable discussing patient care/clinical presentation of the patient (as it relates to quality metrics and coding) with providers
• Able to present to both small and large (up to 100) groups
• Initiates judgment, makes decisions, and works autonomously
• Ability to work with a variety of stakeholders at various levels of authority within the organization
• Problem solving and conflict resolution
• Analytical and critical thinking skills