Clinician Coding Analyst
advocate Health Care
Major Responsibilities:
Oversees and standardizes for improvements of Find-My-Coding Liaison and other internal Liaison team statistical tracking tools for clinician/clinical educational touchpoints for reporting to Professional Coding department leadership.Maintains and supports necessary schedules for Liaison team clinician onboarding and training, recurring progress check-ins, quality checks, shadowing new clinician coding orientations and educational reviews. Working in collaboration with professional coding and clinical leadership and physician recruitment.Oversees the utilization of monitoring tools or other applications to track and report the progress of the New Clinician Coding Orientations. Provides education/feedback to the Liaison team. Maintains a current understanding of regulatory trends and changes in coding policy and reimbursement that affect the organization by monitoring governmental resources to assess regulatory changes and determine organizational impact.Participates in various team projects including but not limited to researching new services, performing quality checks, presenting coding and documentation education, and following up with Liaisons on new clinician orientation onboarding to ensure completion is timely.Coordinates with and participates with internal and external partners in the development and approval of clinician education for Hierarchical Condition Categories (HCCs) CRA Tip of the Month educational documents, PowerPoints, One-Pagers, and/or ad-hoc coding and documentation educational materials, as neededPerforms ongoing query analysis to identify opportunities to improve and ensure appropriateness of the query process and bring to supervisor(s) attention, any issues that need addressing. Oversees query processing addressing concerns from Liaison team members by triaging issues. Identifies and communicate trends to the appropriate teams, including Professional Coding Leadership and Health Information Management (HIM).Coordinates with Liaison team to report and assist in resolving coding, billing, and compliance issues working with internal and external partners including but not limited to: PB and HB coding, Billing, Health Information Management (HIM), Clinical Risk Adjustment (CRA), Clinical Informatics/Clinical Informatics Educators, Quality Improvement Coordinators (QIC) Medical Group Compliance, Internal Audit, Physicians/APCs, and/or clinic leadership.Serves as temporary support with Epic transfer query WQ coverage for open Liaison positions during the recruitment and onboarding process, as needed.Maintains up-to-date expert knowledge of Medicare, Medicare Advantage, Medicaid, and other regulatory requirements pertaining to nationally accepted coding policies, standards, and risk-based methodology; including CMS & IMO updates affecting ICD-10/HCCs, CPT, ICD-10/HCC HCPCS and modifier coding practices, clinical/charge capture Epic functionality, internal processes; and maintains professional and technical knowledge through webinars, workshops, professional publications, and personal networking.
Education/Experience Required:
Knowledge, Skills & Abilities Required:
Licensure, Registration and/or Certification Required:
Coding Associate (CCA) certification issued by the American Health Information Management Association (AHIMA), orCoding Specialist - Physician (CCS-P) certification issued by the American Health Information Management Association (AHIMA), orHealth Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA), orHealth Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA), orProfessional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC), orSpecialty 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).
Physical Requirements and Working Conditions:
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.
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