Coding Liaison, Professional Billing Coding

Hennepin Healthcare; Minneapolis (MN); Remote; USD 65,000 - 90,000; Full time

Job summary

Hennepin Healthcare is seeking a Professional Billing Coding specialist to support coding and billing education, compliance reviews, and revenue integrity across the organization. The role emphasizes collaboration with physicians, APPs, residents, and coding staff to optimize documentation and coding accuracy.

The position requires HIM education or coding credentials and a strong ability to analyze data and present findings to diverse stakeholders.

Qualifications

• Two years post-secondary education in HIM required.
• Three years external coding/reimbursement experience required.
• RN or coding certifications required (CCS-P, CPC, RHIT, RHIA, CDIP, CCDS).

Responsibilities

• Assists with New Provider Onboarding.
• Presents education points to physicians, APPs, 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 stakeholders to outline and institute strategies for improvement.
• Collaborates with other departments to determine trends and educational needs.
• Analyzes provider documentation and billing practices to identify opportunities for revenue capture and compliance concerns.
• Performs annual CPT and ICD-10-CM reviews, communicates changes to impacted clinical departments.
• Supports clinical areas in charge capture and coding accuracy to ensure uniformity of charges.
• Identifies issues with medical necessity, coding, and billing; recommends actions to improve processes.
• Conducts annual provider quality reviews to evaluate service appropriateness and documentation.
• Other duties as assigned.

Skills

Interpersonal skills

Data analysis

Collaboration

Problem solving

Time management

Quality metrics

Educational outreach

Education

Two years post-secondary HIM education

Three years external coding/reimbursement experience

RN

CCS-P, CPC, RHIT, RHIA

CDIP, CCDS

Bachelor's degree in health related field

Job description

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 foundConducts 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