Hospital Coding Liaison

Orlando Health•Orlando, FL

12d

About The Position

The Hospital Coding Liaison is responsible for supporting accurate and efficient coding across Orlando Health System facilities. The role reviews medical records and resolves problem accounts, provides coding education, supports compliant billing and quality reporting, and helps ensure optimal reimbursement in accordance with established coding rules and regulatory guidelines. Liaisons may support inpatient, outpatient, or radiation oncology coding functions. They collaborate with coding, revenue management, clinical documentation excellence, quality management, physicians, and other stakeholders; analyze review trends; and contribute to process improvement, reporting, and education. The role also supports coding application testing and troubleshooting, serves as a preceptor for new coders, maintains professional certification, and is expected to meet a 95% or higher accuracy rate.

Requirements

Bachelor's degree in Health Information Management, associate degree in Health Information Management, or completion of a coding certificate program.
Thorough knowledge of official coding guidelines from AMA, AHA, and CMS.
Computer literacy and knowledge of anatomy, physiology, and medical terminology.
Advanced knowledge of anatomy, physiology, pathophysiology, pharmacology, and medical terminology to translate medical documentation into the appropriate classification system.
Coding skills test score of 90% or better.
One of the following certifications: CCS, RHIA, RHIT, CPC, or COC.
Seven years of relevant hospital inpatient and/or outpatient coding experience.
For inpatient liaison work, advanced knowledge of sequencing guidelines and ICD-10, ICD-10-PCS, MS-DRG, and APR-DRG.
For outpatient liaison work, advanced knowledge of ICD-10 and CPT coding and NCCI and external payer edit resolution.
For radiation oncology liaison work, three years of radiation oncology coding experience in lieu of the seven-year teaching hospital experience requirement.
Strong computer literacy, including Microsoft Word and Excel experience.

Nice To Haves

One year of teaching hospital coding experience.
Level One Trauma hospital experience for inpatient liaisons.

Responsibilities

Review medical records for accuracy of principal and secondary diagnoses, comorbid conditions, complications, procedure codes, and other abstracted elements to support 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.
Respond to internal and external coding questions and provide expert feedback on coding issues.
Participate in coding meetings and education sessions, share coding knowledge, and develop and present educational materials to stakeholders.
Communicate and collaborate with coders, physicians, physician extenders, physician offices, coding and management teams, and Revenue Management colleagues.
Review patient records and identify coding trends, areas for focused review, and recommendations for corrective action, performance reporting, process improvement, and education.
Assist with Discharge Not Final Billed account reviews to support timely code completion and accurate billing across multiple hospitals.
Review discharge disposition and other abstracted data to maintain department quality standards.
Act as a team leader and provide support to the regional manager.
Assist with coding application testing, reporting, data trending, and troubleshooting.
Serve as a preceptor to new coders.
Comply with AHIMA and AAPC Standards of Ethical Coding and official coding guidelines; attend required departmental and interdepartmental meetings and use departmental coding resources.
For inpatient liaison work, apply sequencing guidelines and knowledge of ICD-10, ICD-10-PCS, MS-DRG, and APR-DRG; collaborate with Clinical Document Excellence and Quality Management on appropriate DRG assignments; and assist with inpatient coding as needed.
For outpatient liaison work, apply ICD-10 and CPT coding knowledge, resolve NCCI and external payer edits, and assist with outpatient coding as needed.
For radiation oncology liaison work, apply radiation oncology coding, modality, and billing knowledge; validate modality procedure charges against charts; and read treatment plans to identify MUEs and devices.
Develop and update departmental processes, pursue professional growth, maintain certification, and perform other assigned duties.
Maintain reasonably regular and punctual attendance and comply with Orlando Health policies and procedures.
Maintain coding accuracy at 95% or higher.