Lead Coding Reimbursement Coordinator

Harris Health System

5d

About The Position

Harris Health System is the public healthcare safety-net provider established in 1966 to serve the residents of Harris County, Texas. As an essential healthcare system, Harris Health champions better health for the entire community, with a focus on low-income uninsured and underinsured patients, through acute and primary care, wellness, disease management and population health services. Ben Taub Hospital (Level 1 Trauma Center) and Lyndon B. Johnson Hospital (Level 3 Trauma Center) anchor Harris Health's robust network of 39 clinics, health centers, specialty locations and virtual (telemedicine) technology. Harris Health is among an elite list of health systems in the U.S. achieving Magnet® nursing excellence designation for its hospitals, the prestigious National Committee for Quality Assurance designation for its patient-centered clinics and health centers and its strong partnership with nationally recognized physician faculty, residents and researchers from Baylor College of Medicine; McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth); The University of Texas MD Anderson Cancer Center; and the Tilman J. Fertitta Family College of Medicine at the University of Houston. JOB SUMMARY: Supervises and monitors daily workflow distribution and processes in addition to performing general supervisory duties involving reimbursement coordinators, claim edits, denials and appeals on charged based procedures. The Lead Reimbursement Coordinator will oversee outpatient claim edits and denial reviews to ensure timeliness and appropriateness of responses for reimbursement with compliant coding practices. Responsible for providing ongoing education/in-services to coders, providers and other staff related to the trends of denials, procedures, claim edits, and updated NCCJ(National Correct Coding Initiative), MUE(Medically Unlikely Edits), LCD/NCD ( Local and National Coverage Determinations). The Lead will serve in an advisory role for coding and regulatory regulations. Maintain the confidentiality of patient records and procedures.

Requirements

• Associate's degree in health-related discipline
• RHIA/RHIT credentials preferred, CCS/CCS-P or CPC/COC credentials or LVN certification required
• Five (5) years of outpatient-based hospital coding and/or charge capture experience or coding review experience
• Above Average Verbal (Heavy Public Contact)
• Exceptional Verbal (e.g., Public Speaking)
• Writing /Composing (Correspondence/Reports )
• Analytical
• CRT
• Medical Terms
• P.C.
• Research
• Statistical
• Word Proc
• Flexible Work Schedule
• Detailed knowledge of coding conventions and rules established by the American Medical Association (AMA), the Center for Medicare and Medicaid Services (CMS), the ICD-10-CM Official Coding Guidelines, AHIMA, and AAPC for assignment of diagnostic and procedural codes
• Detailed knowledge of medical terminology, abbreviations, anatomy and physiology, major disease processes, and pharmacology.
• Detailed knowledge of classification systems, ICD-10-CM nomenclature , CPT-4, and HCPCS nomenclature, coding rules, guidelines, and proper sequencing
• Knowledge of DNV, Privacy Act of 1974, and HIPAA standards
• Knowledge of ethical coding principles and revenue cycle activities
• Skill in interpreting and applying ethical coding standards, understanding federal and state laws and regulations, and following professional practice standards for health care organization coding compliance program activities
• 3M encoder interfaced with EPIC electronic medical record billing system

Nice To Haves

• RHIA/RHIT credentials preferred

Responsibilities

• Supervises and monitors daily workflow distribution and processes in addition to performing general supervisory duties involving reimbursement coordinators, claim edits, denials and appeals on charged based procedures.
• Oversee outpatient claim edits and denial reviews to ensure timeliness and appropriateness of responses for reimbursement with compliant coding practices.
• Responsible for providing ongoing education/in-services to coders, providers and other staff related to the trends of denials, procedures, claim edits, and updated NCCJ(National Correct Coding Initiative), MUE(Medically Unlikely Edits), LCD/NCD ( Local and National Coverage Determinations).
• Serve in an advisory role for coding and regulatory regulations.
• Maintain the confidentiality of patient records and procedures.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees