Full Job Description
Performs, develops, and implements coding related efficiency processes to monitor professional coding in order to ensure optimal efficiency and adhere to regulatory compliance guidelines with governmental and private payers. The Physician Coding Liaison is responsible for analyzing physician coding trends and providing feedback that will contribute to effective efficiencies.
Associate’s degree required. Two (2) years of directly related work experience may substitute for the Associate’s degree (in addition to the requirements listed in the Experience section).
Completion of medical coding certificate program.
Computer literacy, knowledge of Anatomy, Physiology and Medical Terminology required.
Thorough knowledge of official coding guidelines as per AMA, AHA, and CMS as evidenced by results of coding skills test of 90% or better.
Proficient experience in Microsoft Word and Excel or similar computer software is required.
Must maintain one (1) of the following national certifications:
Certified Professional Coder (CPC) through the American Academy of Professional Coders
Certified Coding Specialist (CCS), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Tumor Registrar (CTR) through the American Health Information Management Association (AHIMA)
Certified Medical Transcriptionist (CMT) through the Association for Healthcare Documentation Integrity (AHDI)
Two (2) years management experience within a physician practice or healthcare facility setting.
Four (4) years of medical coding experience may substitute for two (2) years of the required management experience.
Working knowledge of Medicare, Medicaid, managed care and commercial insurance reimbursement policies.
Knowledge of CPT, HCPCS, ICD-9 and ICD-10 coding, and other third party billing rules, reimbursement, and coverage guidelines.
Demonstrated relationship-building skills in a managed healthcare environment.
Guide and educate coding team members by addressing errors, performance issues, and trends identified through reporting.
Takes an active role in developing and presenting educational programs to physicians, physician extenders, and physician offices.
Effectively communicates best practice physician coding related feedback with physicians, non-physician providers, physician office staff, administration, practice managers, and team members of the Physician and Professional Services Central Business Office.
Works in partnership with all necessary Orlando Health Team Members to secure and assemble all necessary physician records to accurately review coding compliance for levels of services in conjunction with the appropriate physician coding programs and resources.
Takes the initiative to identify and solve complex trending coding issues affecting the physician revenue cycle and provide the necessary feedback to correct claims on a go-forward basis as well as recovered underpaid amounts.
Collaborates with Physician and Professional Services Central Business Office to ensure appropriate and complete follow up of patient accounts in order to ensure coding accuracy for payor guideline reimbursement.
Travel to and from the Central Business Office throughout the business day to host and attend meetings at different offsite locations.
Addresses all Orlando Health departments professionally and positively, in all settings, by maintaining a high level of professional demeanor and dress at all times.
Develops and maintains professional relationships with Orlando Health team members and represents the Physician and Professional Services as the Physician Coding Liaison.
Maintains coding related practice management system account follow-up (ETM) tasks and pre-billing (TES) edit workfiles to ensure timely resolution according to organizational expectations.
Provides statistical reports to deliver accurate documentation of ongoing internal coding efficiency process.
Conducts focused physician reviews as needed and provides data to manager on a monthly basis.
Maintains 90% physician coding accuracy rate.
Attends payor, departmental and interdepartmental meetings as required.
Acts and serves as the liaison for all Orlando Health physician-related coding events, issues, and projects.
Prepares/distributes information summarizing opportunities with physician coding on a monthly basis.
Possesses exceptional knowledge in Microsoft Office Word, Outlook, and PowerPoint as well as moderate to expert experience with Microsoft Excel.
Researches, identifies, develops, and assists in implementation of a plan of action to resolve coding disputes with payors.
Develops ad-hoc reports as needed to analyze data to identify trends and take appropriate steps to assist in resolving coding issues that impact charges and revenue.
Utilizes resource material available in department, CMS, AMA, and AHA to support coding practices.
Serves as a preceptor to new coders.
Takes an active role in developing and presenting educational programs to Physician & Professional Services team, physicians, physician extenders, physician offices, and all members of the coding team and manager.
Maintains extreme patient confidentiality.
Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.
Maintains compliance with all Orlando Health policies and procedures.
ADDRESS: 4401 SOUTH ORANGE AVE, ORLANDO, FL
ABOUT ORLANDO HEALTH
Orlando Health is one of Florida's most comprehensive private, not-for-profit healthcare networks, and is based in Orlando, FL. Our facilities, advanced medical treatments and procedures, and highly qualified staff have distinguished Orlando Health as a healthcare leader for nearly two million Central Florida residents and 10,000 international visitors annually. Click here to learn more about Orlando Health.