Coding Liaison, Professional Billing Coding

SUMMARY :

We are currently seeking a Coding Liaison to join our Professional Billing Coding team. This full-time role is designated for the day shift and is primarily remote (approximately 90%). However, occasional on-site presence may be required based on operational needs.

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 :

Preferred Qualifications :

Knowledge / Skills / Abilities :

License / Certifications :