Physician Coding Liaison II – General Surgery and Plastics REMOTE

Major Responsibilities

• Provides proactive coding and documentation education and feedback from trends related to coding changes (CPT including E&M, modifiers, ICD-10-CM,HCPCS, and Risk Adjustment), annual code updates, payer requirements, and payer rejection resolution to assigned Physicians/APCs. Partners with CMOs to standardize coding processes across a specific specialty. Shares and/or virtually presents in individual and/or larger group settings on coding and documentation education presentations to Chief Medical Officers (CMOs), operations leaders, clinicians, and clinical staff across the organization.
• Conducts orientations for all AAH employed Physicians/APCs, including Locum Tenens, residents/students and clinical team members on specialty specific coding and documentation related education. Presents all results from new clinician documentation reviews, low-risk, and/or compliance reviews for coding and documentation educational feedback. Performs spot checks, as requested and triages issues to identify the appropriate teams to address non-coding related concerns to. 
• Coordinates responses to all AAH employed Physicians/APCs, Locum Tenens, residents/student’s questions and feedback from various sources and partners, including physician or service line leadership, operational leaders, Internal Audit, Medical Group Compliance, Physician Compensation, Clinical Informatics/Clinical Informatics Educators, Hospital coding and/or other external partners. 
• Queries on low to moderate coding complexity and/or high complexity(NCCI bundling, high complexity coding to Physician/APC, Locum Tenens, residents/students, and/or clinical staff when prompted by PB Coding Department production and/or MRA coders to assist in resolving coding and documentation questions. Relays any coding changes, feedback, and/or education to Physicians/APCs, Locum Tenens, residents/students and/or clinic staff or leadership, as appropriate. 
• Monitors Epic transfer query WQs (charge review, follow-up, claim edit) and works low-high complexity sessions to resolve in partnership with appropriate clinicians for sessions requiring additional information for assigned clinicians to ensure timeliness of charge submissions to ensure proper supporting documentation for billing and meet timely filing. 
• Attends virtual clinical or physician department meetings, Medical Group CMO or Operations ,Council meetings and/or other service line leadership meetings to share coding and documentation information, as requested. Attends virtual individual Physician/APC meetings to share feedback education that include coding and/or documentation topics, such as clinician educational or low risk review meetings, Risk Adjustment, Medical Group Compliance, and/or other meetings where high complexity coding representation is requested. 
• Collaborates with internal coding teams and external partners including but not limited to: physician champions, CMOs, operations leaders, clinical informatics, risk adjustment, population health and/or others to review and provides coding/documentation guidance on Epic templates, order entry, diagnosis, and charge capture preference lists as well as SmartSets, and/or SmartPhrase development or revisions.
• Develops Physician/APC specialty coding and documentation newsletters and individual Physician/APC scorecards to continually educate/communicate updates from various coding resources including specialty society organizations. Communicates new services performed by Physician/APCs to PB Coding department leadership. 
• Participates in recurring specialty calls with other Professional Coding team members to identify trends and/or other areas of educational opportunities for clinicians to improve their coding and documentation. 
• Presents coding and documentation education for small groups on updates/trends for employed Physician/APC, Locum Tenens, residents/students, and/or clinic leadership, as requested. 
• Collaborates with external department partners in the development of Clinical Risk Adjustment (CRA)educational materials and/or ad-hoc coding and documentation educational materials. 
• Identifies service line/specialty specific trending data and opportunities to capture revenue through documentation improvement. Attends service line/specialty specific coding and/or society conferences, as requested, to gain further knowledge that is uniquely relevant to that specialty and how coding, documentation, and billing are affected. 
• Maintains expert knowledge of Medicare, Medicare Advantage, Medicaid, and other regulatory requirements pertaining to nationally accepted coding policies, standards, and risk-based methodologies

Licensure, Registration, and/or Certification Required:

• Coding Associate (CCA) certification issued by the American Health Information Management Association (AHIMA), or
• Coding Specialist – Physician (CCS-P) certification issued by the American Health Information Management Association (AHIMA), or
• Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA), or
• Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA), or
• Professional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC), or
• Specialty Coding Professional (SCP) certification issued by the Board of Medical Specialty Coding and Compliance (BMSC), and
• Specialty Medical Coding Certification issued by the American Academy of Professional Coders (AAPC) needs to be obtained within 1 year.

Education Required:

• Advanced training beyond High School that includes the completion of an accredited or approved program in Medical Coding Specialist.
• Experience Required:
• Typically requires 4 years of experience in expert-level professional coding and least 2 years educating/training licensed clinicians.

Knowledge, Skills & Abilities Required:

• Specialty Medical Coding Certification must be held in the area(s) you will support.
• Excellent communication (oral and written), adult education, and interpersonal skills. Ability to develop rapport and maintain positive, professional partnerships primarily with employed Physicians, APCs, CMOs, Senior director administrators, Medical Group Operations, and physician coding team members.
• Advanced computer skills including the use of Microsoft office products, electronic mail, video/web conferencing, including exposure or experience with electronic coding and EHR systems or applications.
• Excellent/comprehensive skills in organization, prioritization, problem solving, facilitation skills as well as the ability to have meaningful, albeit, difficult conversations with CMOs/Physicians/APCs and/or Senior Director Administrators.
• Highly proficient in critical thinking and analytical skills with an extensive attention to detail.
• Ability to work independently and exercise independent judgment and decision making.
• Ability to meet deadlines while working in a fast-paced environment.
• Ability to work in multiple work environments (ie virtual, office, clinic/hospital, other).

Physical Requirements and Working Conditions:

• Exposed to normal office environment.
• Position may require travel which will result in exposure to road and weather hazards.
• Operates all equipment necessary to perform the job.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.