Professional Coding Specialist Lead (Multispecialties)

Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you’ll find other important information about this position. Serves as lead responsible for monitoring, maintaining and coordinating work assignments. Performs ongoing audits of select inpatients and outpatient accounts and provides training to ensure optimum reimbursement and hospital coding compliance. Ensures accurate and appropriate information is documented, coded, and entered into the system(s) in order to meet departmental, hospital and outside agency requirements. This includes appropriate reimbursement, verification, compliance, and charging with the various coding guidelines and regulatory agencies. Responsible for obtaining accurate and complete documentation in the medical record for accurate coding assignment, severity of illness and risk of mortality for each medical record. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1.High School Diploma or Equivalent. 2.Current HIM/Coding Certification through ONE of the following: - American Health Information Management Association (AHIMA) - American Academy of Professional Coders (AAPC) EXPERIENCE: 1. Four (4) years of medical coding experience. PREFERRED QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Associates degree in Health Information Management CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned. 1. Monitors, maintains and coordinates work assignments. 2. Processes daily reports. 3. Performs training and in-service education and serves as a coding expert. 4. Performs audits around charging and coding, as assigned. 5. Works with revenue cycle teams to ensure that accurate, timely coding and optimum reimbursement occurs. 6. Assists the management team in the day-to-day operations of the department, as it pertains to reimbursement, coding, abstracting, productivity, quality and education. 7. Assists with development of coding related policies, procedures, query development, work queues and training materials in conjunction with management. 8. Reviews and accurately interprets medical record documentation from all accounts in order to identify all diagnosis and procedures that affect the current inpatient stay or outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure that is identified. 9. Assures that quality and timely coding, charging and abstraction of accounts are completed daily for assigned specialty areas. 10. Maintains and enhances current levels of coding knowledge through quality review, attendance and participation at clinical in-services and coding seminars, internal meetings, study of circulating reference materials, and inclusion of updates to coding manuals. 11. Assures the accuracy, quality, and timely review of data needed to obtain a clean bill. 12. Contacts physicians or any persons necessary to obtain information required to accurately code assignments. Works and communicates with other offices in any manner necessary to facilitate the billing process. 13. Monitors on an on-going basis provider documentation. Performs audits to assess provider coding accuracy and follows up with provider education as needed. 14. Provides assistance to Revenue Cycle Operations in claim development functions to resolve problem patient accounts. 15. Interacts with physician and non-physician providers to maximize correct coding initiatives. 16. Analyzes & resolves issues of missing charges and problem accounts by researching information regarding department reimbursement. PHYSICAL REQUIREMEN