Telehealth Billing and Coding Analyst PSJH

Providence Health & Services

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Providence St. Joseph Health is calling a Telehealth Billing and Coding Analyst PSJH to our location in Seattle, WA or remotely in approved locations within the US.

We are seeking a Telehealth Billing and Coding Analyst PSJH who will have overall responsibility for positioning PHS to implement best practices for Telehealth programs on a multi-state scale, while leveraging the dynamic financial ecosystem to our advantage. Acts as PHS Subject Matter Expert for telehealth coding and billing guidelines, legal and regulatory issues, and payor policies. Responsible for directing research and discovery process, educate stakeholders, and advocate change in policies and processes, and monitor progress. Responsible for collaborating with PHS parallel SMEs and stakeholders to design and implement PHS future strategy and approach for telehealth reimbursement and coding/billing practices.

The incumbent performs all duties in a manner that promotes Providence mission, values, and philosophy. In all aspects, he/she serves as a role model for the values and mission of the organization.

In this position you will have the following responsibilities:

  • Research telehealth billing codes, billing practices, payment policies, and limitations to include Medicare, Medicaid, regional payment policies, as well as PHS policies and practices.
  • Document research findings, analyze data, and make recommendations for required change(s) in support of PHS telehealth business objectives.
  • Act as the change agent, driving for policy and process changes where necessary, internally and externally, while monitoring and documenting progress, and escalating issues where indicated.
  • Provide subject matter expertise, quality review and feedback to regional billing teams.
  • Is the primary resource to PHS stakeholders for telehealth coding and billing guidelines, legal/regulatory issues, and payor policies. Ensure customer satisfaction through follow-up, client responsiveness, and thorough communication; manage partners' expectations.
  • Based on current coding/billing practices, designs and implement a future approach and strategy for collaborating with partners. Responsible for current and future coding and billing practices, and set policies based on the current environment and collaborate with stakeholders to drive that future state. Liaise with appropriate PHS resources to develop strategies for payor negotiation and contracting, including government agencies and commercial payors
  • Develop and implement coding education, policies, procedures, and documentation guidelines for Telehealth providers and staff. Define requirements for ICD-9, ICD-10, CPT, HCPC, and modifiers for Telehealth program development.
  • Design and implement process and product improvements to integrate multistate systems for Telehealth coding/billing issues.
  • Travel to each region to adopt and refine billing processes as they evolve with changing reimbursement rates across the various Telehealth service channels.
  • Build platform for centralizing Telehealth billing and coding
  • Support local physician leaders in the development of coding templates and encounter forms in Epic.
  • Ensure Epic instances and revenue streams are appropriately reconciled.
  • Implement and perform compliance audits for telehealth billing practices in conjunction with regional billing teams.
  • Develop process for data driven analysis to assist in negotiations with payers and to drive organizational performance.
  • Support Telehealth Provider Network and Clinical Operations team on tools and approaches to integrate and automate processes.39:48

Required qualifications for this position include:

  • 7 years billing, coding experience and/or a combination of both, or equivalent experience in a similar healthcare domain.
  • Certified Professional Coder (CPC credential) or Registered Health Information Technician (RHIT) upon hire or holds at least one of the following coding credentials from the American Academy of Professional Coders (AAPC) and/or American Health and Information Management Association (AHIMA):
  • Registered Health Information Management Administrator (RHIA)
  • Registered Health Information Management Technician (RHIT)
  • Certified Coding Specialist (CCS)
  • Certified Coding Associate (CCA)
  • Certified Coding Specialist – Physician Based (CCS-P)
  • Certified Professional Coder (CPC)
  • Certified Professional Coder – Outpatient Hospital (CPC-H)
  • Certified Professional Coder – Payer (CPC-P)"

Preferred qualifications for this position include:

  • Experience in inpatient and outpatient settings.

About the department you will serve.

Providence Shared Services provides a variety of functional and system support services for our Providence family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.

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