Coordinator, Professional Coding Services

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

The position of Coordinator, Professional Coding Services is responsible for collaborating on coding revenue cycle functions, process improvement, and training needs. Coordinates within a coding team-based structure to oversee specialty-based charging functions, coding, clinical document needs, and Epic enhancements and streamline efforts. Serves as the primary point of contact for coding and charging inquires for assigned practices and NEMG specialties.

EEO/AA/Disability/Veteran

• 1. Coding Revenue Cycle Management:
• 1.1. Oversee coding revenue cycle streams for assigned clinical practices and specialties.
• 1.2. Act as the main point of contact for coding and charging inquiries from practices and physicians.
• 2. Collaboration and Workflow Optimization
• 2.1. Collaborate with physician leadership and practices to enhance clinical workflows and reduce coding-related denials.
• 2.2. Optimize clinician charging preference lists and improve workflows in Epic.
• 3. Reporting and Analysis
• 3.1. Prepare and analyze reports to identify coding trends and documentation errors.
• 3.2. Communicate issues to physicians, practices, and clinical staff for resolution.
• 3.3. Regularly update high-level reporting narratives and develop SBAR communications.
• 3.4. Create and submit reports on KPIs, scorecards, and denial identification and mitigation efforts.
• 3.5. Create and monitor coding dashboards and work queues to ensure timely account coding
• 3.6. Analyze trends from internal monitoring and practice findings to inform stakeholders.
• 4. Compliance and Training
• 4.1. Monitor, communicate, and integrate coding and documentation compliance requirements into coding operations.
• 4.2. Conduct and/or coordinate coding educational training sessions for physicians and staff
• 5. Research and Root Cause Analysis
• 5.1. Research new programs, services, and codes to determine coding and charging needs.
• 5.2. Conduct root cause analysis on denied cases and communicate findings to practices.
• 5.3. Navigate government and payer regulations and recommend coding claim edits and documentation templates.
• 6. Denial Management and Improvement
• 6.1. Manage coding-related denials by service and implement corrective measures.
• 6.2. Facilitate biweekly coding huddles and monthly denial meetings.
• 6.3. Collaborate with the SBO, coding teams, payer strategy, NEMG operations, and clinicians/practices to address coding-related issues.
• 7. Stakeholder Communication
• 7.1. Consult with Legal Office, Compliance, and Payer Strategy as needed.
• 7.2. Liaise with physicians and practices to provide training and education on coding and documentation requirements.
• 7.3. Communicate with payer strategy to draft contract language and escalate coding-related denials.
• 8. Special Projects and Initiatives
• 8.1. Participate in special program workgroups and business planning sessions.
• 8.2. Collaborate with other leaders on projects, initiatives, and data reporting.
• 9. Customer Service and Escalation
• 9.1. Oversee and coordinate escalated customer service complaints.
• 9.2. Oversee and coordinate compliance related audits.
• 10. Additional Responsibilities
• 10.1. Create and implement workflows, reporting, and/or other needs to support the efficiency of the coding revenue cycle stream and to communicate out to key stakeholders
• 10.2. Complete other tasks as assigned by departmental leadership.

EDUCATION

Associates degree required. Bachelor's degree or enrolled in a bachelor's degree program or 4+ years of supervisory/managerial experience in lieu of a degree preferred. Master's degree is a plus.

EXPERIENCE

A minimum of 3 to 5 years in healthcare revenue cycle and/or a clinical practice setting. A minimum of at least 1 year in a leadership or supervisory position required. Previous experience with coding/denials, budgeting, reimbursement/claims management, data analysis and relationship management preferred.

LICENSURE

AHIMA or AAPC coding credential preferred.

SPECIAL SKILLS

Presentations and written communication skills necessary. Extensive knowledge of third-party insurance billing regulations directly related to coding. Intermediate excel skills are required. Must be comfortable navigating ambiguity, independently assessing needs and implementing solutions.

PHYSICAL DEMAND

May require travel depending on assignment