Documentation & Coding Consultant

Virginia Mason Franciscan Health brings together two award winning health systems in Washington state � CHI Franciscan and Virginia Mason. As one integrated health system with the most patient access points in western Washington our team includes 18,000 staff and nearly 5,000 employed physicians and affiliated providers. At Virginia Mason Franciscan Health you will find the safest and highest quality of care provided by our expert, compassionate medical care team at 11 hospitals and nearly 300 sites throughout the greater Puget Sound region.

This position is responsible for designing, implementing, and managing ongoing organizational monitoring activities and educational programs to ensure proper reimbursement and compliance with all regulatory statutes. This position works in a consulting capacity and is responsible for identifying compliance issues, analyzing practice patterns, verifying charges, ensuring optimal reimbursement for the organization and interpreting regulatory changes. In addition, this position implements the necessary changes and modifies Virginia Mason’s policies, conveys these changes to the clinical departments and educates staff.

Responsibilities include:

• Develops and maintains effective relationship with assigned clinical sections; including but not limited to the section’s providers, support staff and leadership.
• Works in a consultative capacity in performing audits and providing feedback and education, in accordance with the protocol set by the department and Corporate Integrity.
• Performs annual professional services review for each provider in assigned clinical section, including creating and delivering education/feedback based on the review results.
• Plans, writes, develops and conducts on-going training regarding professional services and risk adjustment revenue and reimbursement.
• Interprets changes in the external regulatory environment and modifies Virginia Mason policies accordingly. Keeps current on regulatory and coding issues.
• Leads or assists in developing educational programs for physicians. Acts as a liaison between physicians, administrative staff, patient financial services, other coding staff, and ancillary staff to resolve issues involving coding, billing, and documentation requirements and procedures.
• Responds to inquiries relating to CPT and diagnosis coding. Develops and keeps current all coding tools.
• Oversees medical record documentation to ensure that services provided are accurate; monitors electronic record regulations assuring compliance and record integrity providing support as necessary.
• Involvement, as an advisor/consultant, in organization-wide initiatives helping to interpret documentation and coding guidelines while providing feedback on how to maintain compliance while enacting the initiative.

• Bachelor's degree or equivalent plus credentialed as a Certified Professional Coder (CPC) or Certified Coding Specialist - Physician based (CCS-P).
• This position requires 1 year of CPT and diagnosis coding experience in a healthcare provider or a third party payer.
• Also required are: demonstrated interpersonal, organizational, analytical, and problem-solving skills; ability to interact tactfully yet assertively with physicians and other professional staff; strong presentation skills and comfort in settings ranging from one-on-one communications to large groups; and good written and verbal communication skills.

Preferred:

• Five years of CPT and diagnosis coding experience in a healthcare provider or a third party payer and 3 years experience as an instructor/trainer.
• Clinical knowledge and exposure to risk adjustment coding..