Job Summary:

The Provider Coding Liaison, reporting to the Manager, Provider Coding Education works directly with the WMCAPS Providers to facilitate specialty specific education and support for all medical billing codes and documentation. The incumbent will Interpret progress notes, operative reports, and charge documents to determine services provided and educate the providers on how to accurately assign CPT, applicable modifiers and ICD-10 coding to these services. They will also work to resolves complex coding scenarios, provide feedback and documentation advice to the providers and assist with the resolution of coding related denials if requested.

Responsibilities:

• • Assists revenue cycle team in reviewing claim denials related to coding and documentation accuracy and completeness and provides department specific education to the providers as needed.
  • Identifies trends and ongoing problems related to medical documentation and recommends possible solutions.
  • Responsible for maintaining current Coding Certification, knowledge of federal and state reimbursement policies.
  • Responsible for annual review of all CPT and ICD-9/ICD-10 codes.
  • Reviews and audits schedules/procedures to ensure complete charge capture and enters charges as needed.
  • Performs random chart audits.
• Follows up with providers where documentation is insufficient or unclear.
• Liaising with physicians and other parties to clarify information.
• Search for information in cases where the coding is complex or unusual and provide education to the provider on how best to assign the appropriate codes
• Develop department specific training documents and meet with the department Directors and providers to provide ongoing education and support.
• Provide education and support to all new providers meeting with them frequently to assure that the provider understands how to accurately assign CPT, applicable modifiers and ICD-10 codes.
• Collaborate with the compliance department and assists with individual provider education as appropriate.
• Is available as a resource to providers for coding advice and productivity impacts.

Experience:

Minimum of three (3) years of experience in coding and/or reimbursement activities is required in a multispecialty practice. A clinical background experience is preferred. Experience with coding software products, Optum Encoder Pro preferred. Knowledge in medical coding and CPT, HCPCS and ICD-10. Knowledge of surgical coding and reimbursement practices/strategies. Knowledge of billing systems, Cerner Millennium preferred. Must have strong knowledge of physician practice coding and regulatory compliance. Must be familiar with CMS Physicians at Teaching Hospitals regulations, as well as reimbursement for services rendered in hospital setting.

Education:

High School Graduate required.Associates or Bachelor's degree preferred.

Licenses / Certifications:

AAPC Certified Professional coder (CPC) and/or AHIMA Certified coding Specialist - Physician (CCS-P)

Other:

NoneSpecial Requirements: Proficient computer skills - MS Word, Excel, and Outlook. Detailed oriented and able to meet targeted deadlines.

About Us:

NorthEast Provider Solutions Inc.

Benefits: