[Hiring] Coding Liaison, Professional Billing Coding @Hennepin Healthcare

Role Description

Provides support, education, and feedback to the Physicians, Advanced Practice Providers, Residents, and Coding Staff on documentation guidelines and billing trends.

• 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 communicates 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.

Company Description