Scheduled Hours

40

Position Summary

This position queries providers and works closely with the Pediatrics Coding Supervisors on coder and physician education as Lead Coder. Responsible for meeting with physicians and administrators as requested. Coding Coordinators are a resource to inpatient coders and assist in training new coders. Performs scheduled or Ad Hoc coder audits. Reviews and resolves Epic edits and assists with appeal requests for accurate and timely billing. Cover coding assignments as needed and cross-cover Coding Supervisor.

Job Description

Primary Duties & Responsibilities:

• Sends queries to providers, as well as, documentation feedback. Works closely with Pediatric Compliance Manager on coder and physician education. Pulls notes, creates spreadsheets, and meets with physicians and administrators as requested.
• Resource to inpatient coders and assists in training new coders. Performs quarterly scheduled coder and ad-hoc coder audits. Assists with in-patient coder assignments based on Epic daily Work Que volumes.
• Resolves Epic edits and other appeals requests to ensure timely billing and accurate billing. Reviews coding and billing reports to ensure accuracy. Identifies issues that require Epic ticket generation.
• Provides feedback to Supervisor on the status of outstanding physician deficiencies and other concerns that may affect daily workflow.
• Manages Epic Work Ques to identify encounters that drop out of the Coder’s filtered work que view; identifies coding topics/issues for monthly coder meetings.
• Acts as Lead Coder covering coding assignments as needed at multiple hospital locations and multiples divisions. Reviews documentation to determine proper CPT and ICD-10 codes for E & M services, procedures, and tests provided by department physicians. Cross-covers for Coding Supervisor as needed.
• Maintains coding certification.
• Develops/implements plan for information intake and claims processing from submission to payment.
• Coordinates with staff to determine special project needs, budget information; submits documentation and implements process modifications.
• Monitors schedules and processes to provide effective follow-up, system maintenance and claims completion.
• Reviews process maps and claims history and organizes and oversees training courses relative to process developments.
• Serves as liaison between department and associations, vendors, public relations offices, etc. regarding coding/claims and special project processes.
• Provides testing processes, test results review and secretarial support for routine and special projects.
• Establishes mailing list, filing and contact source lists.
• Provides backup for front desk, answering telephones, mailing out results and other duties.

Working Conditions:

Job Location/Working Conditions:

• Work is performed Monday-Friday. Some weekends or evenings may be required to meet business needs, as well as, extra hours on a daily/weekly basis during peak times. Daily work is utilized by a laptop (position is eligible for work-from-home).

Physical Effort:

• Typically sitting at a desk or table.

Equipment:

• Office equipment.

The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all job duties performed by the personnel so classified. Management reserves the right to revise or amend duties at any time.

Required Qualifications

Education:

Associate degree or combination of education and experience may substitute for minimum education.

Certifications/Professional Licenses:

The list below may include all acceptable certifications, professional licenses and issuers. More than one credential, certification or professional license may be required depending on the role.

Certified Coding Associate (CCA) - American Health Information Management Association (AHIMA), Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA), Certified Coding Specialist - Physican based (CCS-P) - American Health Information Management Association (AHIMA), Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC), Certified Professional Coder - Apprentice (CPC-A) - Ame