Physician Coding Lead

Schedule: Full-time

Job Summary:

Required: The Coding Lead plans and organizes the operations of the Physician Services Coders, I, II, and III. Responsibilities include monitoring of the coding and auditing in addition to assisting with training; having input into employee evaluations, hiring and disciplinary issues. Assist with denial escalations as well as disagreements between the coder and physician. Designing and presenting process improvement initiatives; and managing resources to meet organizational goals and objectives. Serves as liaison between manager and coding staff.

Education:

Required: BS or AS Degree in Health Management Administration or Health Information Technician from an accredited program and two years exposure to reimbursement and coding principles; OR Certified Professional Coder (CPC) with three years of experience..

Preferred:

Experience:

Required:

Minimum of three years coding experience.

Auditing experience of professional coding and E/M auditing of 2-5 years.

Experience managing multiple projects and staff in fast paced, complex environment.

Knowledge and experience in coding in a multi-practice environment.

Demonstrable working knowledge of office applications (i.e.: Word, Excel, e-mail) required.

Excellent communication, presentation and process workflow skills.

Demonstrates sound judgement and organizational ability.

Possesses ability to balance quality of the coding product with quantity.

Experience in or knowledge of Joint Commission/DNV or CMS requirements for Physician Billing Practices.

Preferred:

Coding management or lead experience in a multi-specialty physician group.

Experienced in auditing both coder and physician coding performance.

Position Requirement(s): License/Certification/Registration

Required: Credentialed by AHIMA/AAPC in one of the following: RHIA, RHIT, CCS, CCS-P, CPC.

Preferred: N/A

Department Position Summary:

The Lead of the PB Coding Department ensures the timely and clinically accurate coding of diagnoses and procedures for patients receiving physician services in the inpatient, ambulatory, physician office setting.

Plans, and organizes the operations of the Clinic Coders in a manner that is compliant and efficient.

Provides leadership for process improvement and redesign to reduce costs, and meet departmental and institutional goals and objectives.

Coaches coding staff and effectively communicates goals, standards, and coding expectations and meeting goals related to both quality and productivity.

Coordinates employee schedules for adequate coverage to meet departmental goals.

Assists the manager with overseeing Coders I, II, and III, including having input into employee evaluations, hiring and disciplinary issues.

Assist with denial escalations as well as disagreements between the coder and physician.

Assists the manager with monitoring the operating budget for the Clinic Coding Department.

Continually reviews workflows and processes to balance workload in the Coding Department to meet targets for completion of coding.

Develops, implements, and monitors procedures, guidelines, and coding compliance plans.

Generates and submits reports to Management on the Clinic Coding Key Performance Indicators (KPI).

Acts as a resource for the Clinic Coding staff as well as serves as a liaison in the organization to address clinical coding related issues and questions.

Monitors and disseminates changes in correct coding initiatives; AHA Coding Clinic; CPT Assistant; and, other laws, regulations, and policies that impact clinical documentation, reimbursement, and coding to ensure compliance.

Benchmarks performance and/or standards against local and national standards.

Performs routine coding quality audits for compliance on mandated coding standards for diagnosis, procedure, and Evaluation & Management level assignment and prepares performance improvement plans based on the audit results.

Collaborates with and educates physicians and clinical staff on coding and documentation guidelines.

Ensure a steady flow of communication between Coding Staff and Providers on coding changes, denials and documentation concerns/needs.