Hospital Coding Liaison

Orlando Health•Orlando, FL

About The Position

The Hospital Coding Liaison ensures coding is accurate and efficient across Orlando Health System through chart reviews, problem account resolution, and coding education in accordance with established rules and regulatory guidelines. The role supports accurate billing, quality reporting, optimal reimbursement, and high-quality abstracted data across multiple hospitals. Liaisons may focus on inpatient, outpatient, or radiation oncology coding and serve as coding subject matter experts and resources for colleagues and stakeholders. The position reviews medical records and coding assignments, identifies trends and opportunities for corrective action, develops and presents education, assists with discharge-not-final-billed account reviews, and supports coding applications through testing, reporting, trend analysis, and troubleshooting. The liaison collaborates with managers, revenue management, physicians, coders, Clinical Document Excellence, Quality Management, and other departments, and may act as a team leader and preceptor. The role requires maintaining certification, professional development, compliance with coding standards and organizational policies, and a coding accuracy rate of at least 95%.

Requirements

High school diploma or equivalent required.
Thorough knowledge of official coding guidelines from AMA, AHA, and CMS.
Knowledge of anatomy, physiology, and medical terminology; these areas are measured by a coding skills test.
Liaison coding skills test score of 90% or better required.
Advanced knowledge of anatomy, physiology, pathophysiology, pharmacology, and medical terminology to translate documentation into the appropriate classification system.
Must maintain one of the following certifications: CCS, RHIA, or RHIT through AHIMA; CPC through AAPC; COC; or CPC-H.
Seven years of relevant hospital inpatient and/or outpatient coding experience required for inpatient and outpatient liaisons.
Radiation Oncology Liaison: three years of radiation oncology coding experience required in lieu of teaching hospital experience.
Strong computer literacy, including Microsoft Word and Excel experience.
Maintain a coding accuracy rate of 95% or above.

Nice To Haves

Associate degree or coding certificate program preferred.
One year of teaching hospital coding experience preferred for inpatient and outpatient liaisons.
Advanced knowledge and experience with ICD-10 and CPT coding in radiation oncology is required for the Radiation Oncology Liaison role.
Advanced knowledge of radiation oncology modalities and billing rules is required for the Radiation Oncology Liaison role.
Advanced skill in radiation oncology modality procedure charge validation based on the actual chart is required for the Radiation Oncology Liaison role.
Advanced skill in reading treatment plans to identify the number of MUEs and devices is required for the Radiation Oncology Liaison role.

Responsibilities

Review principal and secondary diagnoses, comorbid conditions, complications, procedure codes, and other abstracted elements against medical record documentation for billing compliance, quality reporting, and reimbursement.
Assign accurate ICD-10-CM, ICD-10-PCS, or CPT-4 codes using an electronic encoder and applicable hospital policies and regulatory guidelines.
Serve as a subject matter expert on coding guidelines and respond to internal and external coding-related requests.
Participate in coding section meetings and provide expert feedback and coding education; share knowledge with appropriate stakeholders.
Develop and present educational materials to support accurate and compliant coding.
Communicate effectively with coders, physicians, physician extenders, physician offices, and coding and management teams.
Collaborate with the manager and Revenue Management Team to review patient records and support accurate coding best practices.
Identify trends in review findings, recommend corrective action plans, and submit trends for KPI reporting, process improvement, and education.
Use trend reporting analysis to identify areas for focused review.
Assist with Discharge Not Final Billed account reviews to support timely code completion and accurate billing across multiple hospitals.
Review discharge disposition and abstracted data to meet department quality standards.
Act as a team leader and provide support to the regional manager.
Assist with system testing, reporting, data trending, and troubleshooting coding applications.
Serve as a preceptor to new coders.
Comply with AHIMA and AAPC Standards of Ethical Coding and official coding guidelines.
Attend departmental and interdepartmental meetings as required and use departmental resource materials to support coding practices.
For inpatient work, apply sequencing guidelines and knowledge of ICD-10, ICD-10-PCS, MS-DRG, and APR-DRG; collaborate with Clinical Document Excellence, Quality Management, and other departments on DRG assignments; assist with inpatient coding as needed.
For outpatient work, apply ICD-10 and CPT coding knowledge, resolve NCCI and external payer edits, and assist with outpatient coding as needed.
For radiation oncology work, apply ICD-10 and CPT coding knowledge, radiation oncology modality and billing rules, validate modality procedure charges against charts, and read treatment plans to identify MUEs and devices.
Develop and update internal departmental processes.
Pursue professional growth and development through education and research, and maintain certification status.
Maintain reasonably regular and punctual attendance and comply with Orlando Health policies and procedures.
Perform other duties as needed or assigned.