Coding Liaison, Professional Billing Coding
Hennepin Healthcare
Coding Liaison, Professional Billing Coding
Hennepin Healthcare is an integrated system of care that includes HCMC, a nationally recognized Level I Adult Trauma Center and Level I Pediatric Trauma Center and acute care hospital, as well as a clinic system with primary care clinics located in Minneapolis and across Hennepin County. The comprehensive healthcare system includes a 473-bed academic medical center, a large outpatient Clinic & Specialty Center, and a network of clinics in the North Loop, Whittier, and East Lake Street neighborhoods of Minneapolis, and in the suburban communities of Brooklyn Park, Golden Valley, Richfield, and St. Anthony Village. Hennepin Healthcare has a large psychiatric program, home care, and operates a research institute, philanthropic foundation, and Hennepin EMS. The system is operated by Hennepin Healthcare System, Inc., a subsidiary corporation of Hennepin County. Equal Employment Opportunities: We believe equity is essential for optimal health outcomes and are committed to achieve optimal health for all by actively eliminating barriers due to racism, poverty, gender identity, and other determinants of health. We are committed to equitable care and working in an environment that celebrates, promotes, and protects diversity, equity, inclusion, and belonging. We are committed to bringing in individuals with new cultural perspectives to assist in creating a more equitable healthcare organization.
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
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