Providence Health & Services Telehealth Billing Coding Analyst PSJH in Montana
Providence St. Joseph Health is calling a Telehealth Billing Coding Analyst PSJH to work remotely within our footprint states: AK, CA, MT, NV, TX, OR and/or WA.
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We are seeking a Telehealth Billing Coding Analyst PSJH who will join a team that has the 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 for 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.
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.
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.
Required qualifications for this position include:
Education to meet certification, license or registration requirement.
Certified Professional Coder (CPC credential), or. • Registered Health Information Technician (RHIT), 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).
7 years Billing, coding experience and/or a combination of both, or equivalent experience in a similar healthcare domain.
Experience in medical billing.
Experience in a medical inpatient or outpatient admitting setting.
Track record of delivering high levels of customer satisfaction.
Demonstrated track record in change management.
Preferred qualifications for this position include:
- 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.
We offer comprehensive, best-in-class benefits to our caregivers. For more information, visit
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Project & Program Management (Non-Clinical)
Other Location(s): Montana, Nevada, California, Oregon, Washington, Texas, Alaska
Req ID: 312011