Professional Coding Analyst

EvergreenHealth•Kirkland, WA

9d•$34 - $54

About The Position

Responsible for evaluating the effectiveness of coding processes, tracking coding performance over time, and identifying trends and opportunities to positively impact revenue cycle performance across the organization. Supports internal documentation and coding review activities, builds and strengthens relationships with operational department leaders, monitors dashboards, prepares and interprets reports, and recommends process improvements that optimize Epic functionality to management. Acts as subject matter expert on complex professional coding topics. Leads or facilitates process improvement projects for identified areas of improvement. Supports other large scale system implementations and projects with a focus on charge reconciliation and capture.

Requirements

High school diploma or G.E.D
Current professional coding credential: AAPC (Certified Professional Coder [CPC], Certified Outpatient Coder [COC]), PMI (Certified Medical Coder [CMC]), or AHIMA (Certified Coding Specialist-Physician [CCS-P], Certified Coding Associate [CCA], Certified Coding Specialist [CCS], Registered Health Information Administrator [RHIA], Registered Health Information Technician [RHIT])
3 years of professional coding experience in a multi-specialty medical group setting.
Possess advanced skills in Microsoft Office with emphasis on Excel advanced functions and PowerPoint.
Extensive knowledge in ICD-10, CPT and HCPCS coding for professional services with emphasis on major surgical procedures for multiple specialties.
Proficient understanding of Epic functionality related to professional coding charge review, denials, and claim edits.
Proficient knowledge in medical terminology, coding and sequencing guidelines.
Comprehensive understanding of anatomy, physiology and disease processes.
Expanded understanding of payer billing requirements, managing denials, payer policies, and navigating payer platforms.
Excellent written and verbal communication skills.

Nice To Haves

5 years of professional coding experience in a multi-specialty medical group setting.
AAPC specialty surgical certification(s): Certified Cardiology Coder [CCC], Certified Cardiovascular and Thoracic Surgery Coder [CCVTC], Certified Gastroenterology Coder [CGIC], Certified General Surgery Coder [CGSC], Certified Interventional Radiology Cardiovascular Coder [CIRCC], Certified Obstetrics Gynecology Coder [COBGC], Certified Ophthalmology Coder [COPC], Certified Orthopedic Surgery Coder [COSC], Certified Urology Coder [CUC]).
Experience with Excel Power Queries
Experience using Epic SlicerDicer

Responsibilities

Analyzes Professional Coding denial data.
Identifies trends by performing trend analysis.
Prevents future denials by developing and recommending new and innovative methods or solutions to identified issues.
Analyzes and identifies trends within coding change data. Researches and identifies opportunities for coder education or process automation.
Reviews charge capture audit reports to verify appropriate charges are captured.
Monitors the professional coding WQs to identify patterns/trends and investigate potential issues.
Develops and monitors PB dashboards, Key Performance Indicators (KPI) data, and coordinates Professional Coding analytics.
Collaborates with IT to leverage Epic technology to improve efficiency and foster automation within the Professional Coding Department.
Collaborates with clinical areas, Professional Billing, and IT to develop and implement new coding and charge capture workflows.
Builds strong relationships and facilitates effective communication with clinical areas and operational leadership.
Creates and distributes Epic reports to key stakeholders at scheduled intervals.
Develops presentations, reports, and educational materials that effectively communicate information to support Professional Coding revenue cycle optimization.
Monitors Epic build for CPT charges to optimize revenue and collaborate across clinical operations, finance, and IT to facilitate resolution.
Evaluates annual coding changes to determine Epic build.
Works with IT to implement identified changes.
Performs other duties as assigned.