LCMC Health-posted 3 months ago
Full-time
New Orleans, LA
501-1,000 employees

The Coder Lead will code all patient types as needed; inpatient, same-day surgery, ancillary, ambulatory and provider based clinics. This individual will mentor, train and assist with cross training coding staff, includes newly hired coding staff. Must be familiar with reviewing documentation to assign appropriate CPT/HCPCS and ICD-10-CM-PCS diagnosis codes and procedures for hospital and physician (professional) services for Inpatient and Outpatient records based on knowledge of coding systems, including ICD-10 and CPT. Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs and APCs. Codes complex outpatient or inpatient utilizing encoder software, Computers Assisted Coding (CAC), and reference, in the assignment of ICD-10-CM/PCS, CPT/HCPCS codes, MS-DRG, APR-DRG, POA, SOI, ROM assignments, APC assignment and all required modifiers. Validates charges by comparing charges with health record documentation as necessary. Utilizes retrospective edit tool to address possible coding and/or documentation issues related to submitted diagnosis and procedure information obtain from the health record. Communicates effectively with clinical staff, physicians and office staff and Clinical Documentation Improvement Specialist regarding documentation issues or needs related to Inpatient, Outpatient, or Ambulatory coding. Identifies concerns and notifies appropriate leadership for resolution. Responsible for providing resolution to moderate to complex problems. Tracks issues (i.e. missing documentation, charges and physician queries) that require follow-up to facilitate coding in a timely fashion. Consistently meets or exceeds coding quality and productivity standards established by coding department. Adheres to LCMC confidentiality requirements as they relate to release of any individual or aggregate patient information. Maintains up-to-date knowledge of changes in coding and reimbursement guidelines and regulations. Performs other duties as assigned by leadership. Maintains working knowledge of applicable coding and reimbursement Federal, State and local laws and regulations, the Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.

  • Code all patient types including inpatient, same-day surgery, ancillary, ambulatory and provider based clinics.
  • Mentor, train and assist with cross training coding staff, including newly hired coding staff.
  • Review documentation to assign appropriate CPT/HCPCS and ICD-10-CM-PCS diagnosis codes and procedures.
  • Navigate patient health records and other computer systems to determine diagnosis and procedure codes.
  • Code complex outpatient or inpatient cases utilizing encoder software and Computers Assisted Coding (CAC).
  • Validate charges by comparing with health record documentation.
  • Utilize retrospective edit tool to address coding and documentation issues.
  • Communicate effectively with clinical staff, physicians, and office staff regarding documentation issues.
  • Identify concerns and notify leadership for resolution.
  • Track issues requiring follow-up to facilitate timely coding.
  • Meet or exceed coding quality and productivity standards.
  • Adhere to confidentiality requirements regarding patient information.
  • Maintain up-to-date knowledge of coding and reimbursement guidelines.
  • Perform other duties as assigned by leadership.
  • Minimum three (3) years of current complex outpatient and inpatient coding experience.
  • Completion of an AHIMA or AAPC approved coding program.
  • Associate degree in health information management or related field or equivalent combination of education and experience.
  • Certification as Certified Coding Specialist (CCS) from AHIMA or AAPC.
  • Certification as Certified Inpatient Coder (CIC) from AHIMA or AAPC.
  • Certification as Certified Professional Coder (CPC) from AHIMA or AAPC.
  • RHIA/RHIT certification is preferred.
  • Internal staff who are not certified must obtain medical coding certification within twelve months.
  • Extensive knowledge of medical terminology, anatomy and physiology.
  • Experience utilizing encoding/grouping software.
  • Knowledge of ICD-10-CM, ICD-10-PCS, CPT/HCPCS coding principles.
  • Experience in ICD-10-CM/PCS coding and reimbursement training.
  • Knowledge of Prospective Payment System (PPS) methodology.
  • Experience with concurrent coding reviews.
  • Knowledge of privacy and security regulations.
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