Physician Billing Coding Lead

Ann & Robert H. Lurie Children’s Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children’s Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report.

Location

680 Lake Shore Drive

Job Description

Summary:

The Pro-Fee Coding Lead will be responsible for reviewing medical documentation and assigning CPT and ICD-10 for various department of the organization. The Pro-Fee Coding Lead will work collaboratively with the Coding Manager, Physician Billing to maintain day-to-day coding operations and various projects and duties assigned.

Essential Job Functions:

•    Performs coding functions as needed for Lurie/Outreach Locations.
•    Monitors coder’s productivity by collaborating with Coding Manager to meet designated productivity and quality benchmarks.
•    Resolves questions, issues and patient disputes with third party payors, billing coordinators, compliance auditors, external billing company and denial management team that pertain to coding.
•    Prepares department coding feedback materials based on trends and issues identified via Coding WQ’s and coding denial trends.
•    Works with Coders and Audit Manager to resolve denials, identify trends and implement process improvements to increase clean claim rate and improve denial recovery rate.
•    Collaborates with Coding Manager to improve Charge Review Work queues workflow thru various WQ improvement initiatives.
•    Collaborates with Coding Manager regarding content for Coders Monthly Meeting including preparing education materials, room reservation and other tasks requirements.
•    Collaborates with Coding manager to perform and complete revenue cycle coding projects
•    Develops and maintains division specific coding protocols.
•    Assists Coding Manager with employee time management on a weekly basis including staffing coverage.
•    Assigns appropriate ICD-10-CM diagnosis code(s), CPT procedure codes and modifiers using coding conventions, guidelines and payor specific requirements.
•    Abstract and compile data from medical records for appropriate optimal reimbursement.
•    Works actively with physicians to initiate corrections and resolve discrepancies in coding and documentation.
•    Works collaboratively with physicians to assure accurate and timely submission of claims.
•    Provides feedback at division meeting around documentation and coding. 
•    Submits help desk tickets and CIS for coding and collaborates with IM for resolution.
•    Collaborates with Coding Manager on month end close numbers for coding.
•    Provides regular communication and education to providers and other clinical teams as indicated.
•    Acts in the capacity of liaison to providers, managers and other coding team members.
•    Ensures that all charges are submitted accurately and in a timely manner.
•    Works collaboratively with Compliance Auditors to identify trends, billing opportunities and physician education needs.

•    Performs job functions adhering to service principles with customer service focus of innovation, service excellence and teamwork to provide the highest quality care and service to our patients, families, co-workers and others.
•    Performs other related duties as assigned.

Knowledge, Skills, and Abilities:

•    Minimum Of Associate Degree is Required. High School Diploma required.
•    Coding credentials required such as RHIT, RHIA, CPC, CCS-P and other surgical coding credentials. 
•    Requires  3-5 years coding work experience.
•    Working and performance knowledge for divisions within the assigned coverage area preferred
•    Management and Project Management preferred
•    Demonstrates thorough knowledge of CPT and ICD-10-CM coding.
•    Maintains a thorough understanding for medical record practices, standards, regulations, Joint Commision on Accreditation of Health Organizations (JCAHO) and Illinois Medicaid coding and reporting requirements.
•    Demonstrates understanding of medical terminology, anatomy and physiology and coding classification systems and is able to apply this knowledge in determining appropriate physician coding.
•    Demonstrates the ability to communicate effectively with providers, co-workers and managers.
•    Demonstrates the ability to work independently and balance multiple priorities.
•    Demonstrates the ability to use multiple types of computer software (i.e., Word, Excel, E