Coder Team Lead is a key associate at Hope Network whose primary
responsibilities include: This position will be responsible for providing
proper coding for services billed at Hope Network. Also, conducting
coding/billing audits on documentation to ensure it supports codes billed for
reimbursement, providing education and communication of process improvements on
inpatient and outpatient coding. Monitor the accuracy and efficiency of the
documentation and coding with providing tools and resources for improving
accuracy or implementing changes. Implement an effective education and
communication process for all coding and monitor the accuracy and efficiency of
the documentation and coding staying current with new regulations and changes.
This position is also responsible for the accuracy of CPT, HCPCS, ICD-10 codes,
modifiers and editing of charges before billing and/or after a rejection from
presentations, develops educational material, handbooks and other training materials.
Audits current coding practices and works directly with coders, billers, and
clinical staff to provide feedback and education as needed. This position may
also assist with daily inpatient/outpatient coding as needed.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
not intended to be an exhaustive listing of job functions. This job
description is in no way states or implies that these are the only duties to be
performed by this employee. The employee is required to follow any other
instructions and to perform any other duties as assigned.
1. Regular and predictable attendance is an
essential requirement of this position.
all applicable diagnostic codes are used and follow ICD-10 coding guidelines
on-site assistance to staff from all locations with coding issues.
assistance as needed in the review of overpayments.
systems and procedures to organize the billing office for maximum efficiencies.
that computer system procedures including, but not limited to, end of day
reconciliations and report printing are completed.
for day-to-day application of clinical coding guidelines and recommends
operational improvements to get to coding quality accuracy.
performance of all coding staff using key metrics including, but not limited to
daily coding volume, assignments worked, client project deadlines and coding
accuracy performance to achieve and maintain a 95% coding quality accuracy
Production and QA concerns or roadblocks to the Director of Revenue Management
for involvement as needed. Work closely with the Training teams members to
communicate progress across the Team to the Manager.
and reviews both production and quality accuracy reporting and/or system
reports on progress for all assigned projects in the Clinical Coding Services
Department to assist with project coordination and completion. These reports
are reviewed daily, weekly, monthly, quarterly and yearly as needed.
team members through effective training and coaching to improve quality and
professionalism on work assignments. Conducts monthly team meetings and annual
performance evaluations with team members.
any special projects, such as full coding audit, and other duties as assigned
in a timely manner.
staff to maximize performance and potential.
in maintaining and monitoring team member job satisfaction and morale.
all special projects and other duties as assigned.
a working knowledge of and follows all CPT, HCPCS, and ICD-10 rules and
statistical information to be included in reports for Revenue Management
meetings with Business Directors on statistical findings.
all other designated projects relevant to position description.
to other Hope Network sites when needed and requested.
Educational / Talent Requirements:
degree in a related field; Business, Finance or Health Administration or the
equivalent of applicable work experience.
Coding Certification for professional services from a nationally recognized
organization (CPC or CCS, CCS-P) required by either AAPC or AHIMA.
have a complete understanding of CPT, HCPCS and ICD-10 guidelines.
ability to communicate in both written and verbal format to meet position
ability to use word processing, spreadsheet and computerized billing programs
to plan, organize and prioritize work on a daily basis.
organizational skills, attention to detail.
Work Experience Requirements:
– 4 years prior work experience in coding and/or auditing medical charts.
in data processing and total business office procedures.
knowledge of CPC, HCPCS and ICD-10 rules and guidelines.
to interact effectively with individuals, employees, referral sources, vendors
and other designated individuals.
to travel to other Hope Network sites when needed and requested; valid driver’s
license with acceptable driving record.
to articulate and actively support the mission of the corporation to various