Lead Coding Specialist
Responsible for the daily oversight of the medical coding processes and staff performance.Monitors the coders performance by analyzing productivity and accuracy. Assures the distribution of daily work to each coder in order to optimize and maintain coding TAT and quality standards. Supports optimal performance of coding software with IT Department. Is a resource to all HIM staff, as needed, to assure optimal HIM coding operations. Requires coordination and communication with other personnel managers and with physicians to support timeliness and operational workflow.
1) Oversees the coding of medical records using ICD-10-CM, HCPCS and CPT with expertise in modifiers, coding guidelines and billing compliance.Codes ICD-10 diagnoses in accordance with coding and departmental guidelines. Utilizes CPT codes with modifiers in accordance with coding and departmental guidelines. Compliance with medical necessity guidelines. Using coding and billing guidelines identifies areas that require further education to coding, fiscal and physician staff. Uses coding expertise to resolve coding and billing issues
2) Excellent communication skills that allows for open discussion as to the processing of a claim, revolution of codes chosen for new services being offered coordinating coding services for best utilization of staffing and resources.
3) The incumbent must have the ability to assess and recommend operational changes to enhance performance of the coding unit to the manager.
4) The incumbent must demonstrate an understanding of team concepts and ability to provide team building skills to staff
5) Supports development and updates to department policies and procedures
6) Communicates with manager all areas of concern, training and educational opportunities, and productivity and quality standards.
7) Provides support regarding reviews and resolutions of coding denials.
8) Works with Patient Accounting and Physicians as needed to identify opportunities regarding coding and documentation. Communicates with physicians if diagnosis and procedures need clarification in courteous, professional manner at all times. Oversees and assists with physician query management.
9) Interdepartmental Communication. Provides courteous, timely and supportive communications to all service lines to resolve any coding/billing issues. Develops reports as needed from coding applications Reconciles accounts collaboratively with Revenue, Billing, Finance in a timely manner.
Required Work Experience:
1) Working knowledge of ICD 10 and CPT and guidelines
Preferred Work Experience:
1) Experience with Hospital EMR and coding application systems (3M and CIS ideal)
Skills and Competencies:
1) Knowledge, comfort and experience with Microsoft Office applications - spreadsheets, PowerPoint, Word etc Ability to work independently and maintain the highest levels of confidentiality.
GED or HiSET (Required)
Certified Coding Specialist - American Health Information Management Association, Certified Professional Coder - Various
Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.
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