Providence Health & Services Senior Coding and Compliance Liaison PSJH in Renton, Washington
Providence is calling a Senior Coding and Compliance Liaison (PB) PSJH to Providence Health & Services in Renton, WA.
We are seeking a Senior Coding and Compliance Liaison (PB) PSJH to work throughout Providence Health & Services in revenue cycle systems and structures in support of our ministries and operations in all regions from Alaska to California. ORC’s objective is to ensure our core strategy, One Ministry Committed to Excellence, is enhanced along with the overall patient care experience (know me, care for me, ease my way) by delivering a robust foundation of services, operational and technical support, and the sharing of comprehensive, relevant, and highly specialized revenue cycle expertise.
This position independently performs highly complex and detailed coding education and auditing and will serve as a liaison between the Coding & Compliance team in WA/MT and the 5 WA & MT regions’ leadership, physicians and non-physician providers. This position will travel to each WA/MT region to meet with leadership and providers to develop the relationship between the Coding & Compliance Team and each region regarding coding, compliance, documentation quality and to address sensitive issues and compliance concerns that may arise. This position will need to work closely with the regional leadership teams, the PBO Billing team, as well as all physicians, non-physician providers, compliance personnel and coding and billing staff in all regions of Providence Health & Services, with particular focus in WA & MT.
In this position you will have the following responsibilities:
Independently perform highly complex and detailed coding review and audit to assess and mitigate risk.
Provide subject matter expertise, quality review and feedback to staff in the Physician Billing Coding & Compliance team, Physician Billing Production Coding team, physicians, non-physician providers and clinic leaders.
Develop educational programs for providers based on audit findings, as well as general education on coding, documentation guidelines, reimbursement rules and regulations.
Create and present customized coding training and initial audit/review for new physicians/providers.
Routinely travel to each region to build relationships with regional leadership and providers in WA/MT.
Provide classroom and individual education to clinic managers, support staff, production coders, billing staff and others as requested.
Perform routine performance and productivity audits of Coding & Compliance staff.
Advise the Physician Billing office regarding coding denials and recommends appropriate billing corrections and/or insurance follow-up guidance.
Provide technical direction and advice to the C&C staff under the direction of the C&C Manager.
Support local physician leaders in the development of coding templates and encounter forms in the EMR system.
Assist the Coding Manager with developing and maintaining department policies and procedures.
Recommend potential areas for improvement in meeting the Coding and Compliance operations strategy and organizational goals.
Lead projects for the Coding and Compliance team as assigned.
Required qualifications for this position include:
High school Diploma or GED equivalent
7 years progressively responsible health care experience in a multi-specialty physician group practice with extensive experience with CPT, ICD-10 & HCPCs coding.
5 years of experience conducting provider education and audits.
Current CPC or CCS-P required.
Current Coding Auditor credentials (ACS E/M, CEMC, CPMA or equivalent)
1 year Current Certification in Specialty coding (i.e. CGSC, CIRCC, COBGC, CCC, COSC)
Demonstrated management skills and ability to work effectively to build relationships with colleagues, customers, and executive management through positive interaction
Demonstrated experience in statistical analysis and data audits for all necessary projects, to include analyzing data from report to summarize, draw conclusions and trending of data.
Demonstrated experience in strong computer skills necessary. Must be proficient in the use of word processing (Word preferred); spreadsheet (Excel preferred); database (Access preferred). Helpful to be knowledgeable in report and presentation design and preparation.
Proven ability to effectively interact with leadership (including COO, CEO, CFO, Medical Directors, and Executive Directors), physicians, clinic managers and support staff.
Ability to travel to other clinic locations in Washington & Montana and other locations as needed.
In depth knowledge of Federal, State, Local and contract specific requirements is necessary to accurately function in a multi-payer environment. As regulations change frequently and often conflict between payers, determining appropriate action for each payer is complex.
Preferred qualifications for this position include :
- 8 years progressively responsible health care experience in a multi-specialty physician group practice with extensive experience in surgical coding, documentation guidelines and chart auditing and fluency in CPT, ICD-10/ICD-9 & HCPCs coding.
About the department you will serve.
Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence Health & Services from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
We offer a full comprehensive range of benefits - see our website for details
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Coding
Req ID: 186383