Certified Medical Coding Lead
Position Summary: The Medical Coding Lead must be a certified medical coder who has experience coding surgeries (inpatient & outpatient), E/M and clinic procedures. This individual will mentor, train and assist with cross training the coding staff, including new hires. The Lead must be familiar with reviewing medical/clinical documentation to appropriately bill using CPT, ICD10CM or HCPCS in accordance with standard coding guidelines and compliance laws. Lead will assist Manager with the oversight of the daily coding operations. Work is performed under the general direction of the Revenue Cycle Coding Manager.
Essential Duties and Responsibilities:
- Responsible for assisting with the day-to-day oversight of the coding staff, this could include establishing staff assignments, preparing schedule for coding response coverage, approving time sheets and providing feedback to the Manager on coder performance.
- Responsible for assisting with the monitoring of coders work queues, evaluate workflows, assigning coders to special projects and help problem solve coding issues.
- Monitor coding operations through audit reports to check for errors and inconsistencies along with compliance of correct coding guidelines.
- Provide training and support to the coding staff.
- Corresponding with Providers and/or PODS to get clarification on documentation or diagnosis codes updated. Assist management with updating and educating providers on documentation and coding requirements.
- Serve as a point of contact along with the Manager to any of the other West teams or departments.
- Possess knowledge to review and reconcile the GYN, ENT, Cosmetic & Breast surgeries, Interventional Radiology Procedures, Radiology, Infusion and Radiation Oncology coding along with basic E/M, labs and pathology.
- Conduct thorough reviews of the medical record to ensure that the clinical documentation supports the capture and billing of charges. Reviewing operative reports, pathology and radiation therapy reports to ensure coding is supported.
- Understands the billing processes, payer explanations of benefits and is able to analyze payer denials to assist in corrections that are returned to West staff by Fedora for investigation and correction.
- Stay up to date with current code books, payer instructions and other bulletins. Attend training and education classes on the current codes and guidelines.
- Respond to queries and emails from Fedora, PODs or other departments.
- Research/Resolves any other coding issue/discrepancy not detailed here, including requesting addendum to documents, correction of supervising provider, etc.
- HIPPA compliant, respecting the dignity and confidentiality of patients.
- Maintains a good attendance record and report on time for work.
- Maintains a professional attitude and appearance.
- Complies with clinic safety policy and procedures.
- Possesses good communication skills that lend to a team-oriented work environment.
- Attends staff meetings as scheduled.
- Assists with training and orientation of new employees as assigned.
- Performs other duties as assigned.
- Remote work and some travel may be required.
Qualifications/Experience:
One year of college or technical school; a minimum of five years related experience and/or training; CCS Certification from AHIMA or CPC Certification from AAPC is required. Oncology, surgery and/or radiology coding experience is a must. Previous lead or supervisory position is a plus
Must have excellent organization and follow-up skills; excellent verbal and written communication skills; excellent problem-solving skills. Must have the ability to organize and prioritize work assignments; ability to handle multiple priorities in a fast-paced environment, analyze situations and respond in a timely manner. Lead must have the ability to participate in multi-functional teams, establish and maintain effective working relationships within The West Clinic. Must be proficient in computer applications. Additional hours may be required.
Work Environment/Physical Demands/Travel:
- Typical clinical environment with moderate noise level.
- Ability to stand, walk, sit and use hand/wrist, talk, hear, see, and stoop or crouch for extended periods of time.
- Ability to read and understand documents such as safety rules, operating and maintenance instructions, procedure manuals, correspondence. Ability to write routine reports and correspondence. Ability to speak and present information in small groups of customers, suppliers, or employees of the company.
- Ability to add and subtract two-digit numbers and to multiply and divide with 10’s and 100’s. Ability to perform these operations using units of US dollars, weight measurements, volume, and distance.
- Ability to lift up to 10 lbs.
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