Provides education in coding and billing to Physicians, Physician Assistants, Nurse Practitioners, and other billing providers to improve the workflow and promote full professional billing revenue capture through overall clinical documentation improvement. Creates communication of important coding and billing information for administrative, operations, and clinical leaders as it relates to their areas. Through extensive interaction with physicians, interdisciplinary health care team members, and business teams, is responsible for facilitating modifications to overall quality and completeness of medical record documentation. Utilizes data and analytical tools to identify and remediate trends and opportunities to maximize professional revenue capture and productivity. Assists in the development of evaluation and management and other billing code utilization reports for comparison to internal and external benchmark data. Supports the improvement of overall coding and billing practices of the physician professional services.
- Associate's Degree or higher in Health Information Management & Systems (or closely related field).
- Minimum five years professional/physician practice billing and coding experience.
- Strong knowledge base and experience in interpreting and applying federal/government regulations to ensure coding and documentation compliance.
- Certified Professional Coder (CPC), Certified Professional Coder-Payer (CPC-P), Certified Coding Specialist (CCS), Certified Coding Specialist- Physician-based (CCS-P).
- Bachelor's Degree in Health Information, Health Care Administration, or related field.
- Three or more years of directly related experience, including leadership.
- Revenue Cycle process experience.
- Payer reimbursement knowledge.
- Experience in surgical specialty professional fee coding, teaching physician rules, and Professional Billing Resolute billing module.
- Experience in analyzing data and using data analytics programs/methodologies.
- Experience in an Academic acute care setting.
- Experience with Epic and/or Cerner systems.