Lead Hospital Coder | Full Time | Medical Records

Memorial Health•Marysville, OH

About The Position

The Lead Hospital Coder accurately codes and audits hospital-based accounts using appropriate coding manuals and/or an encoder. The role follows official American Hospital Association and American Medical Association coding guidelines and H.I.M. Standards of Conduct within the Coding Compliance Plan, supporting quality documentation and appropriate code use for correct reimbursement. The coder enters diagnosis codes, procedure codes, and other required data into the computer system for billing and statistical reporting, and codes patient accounts within five days of discharge when the required documentation is available. The position monitors discharged-not-final-coded accounts and other reports, addresses delinquent or problem accounts, and works with business office personnel to resolve failed claims and support timely billing. It communicates with medical staff when documentation questions affect code assignment, researches coding questions using online and hardcopy references, and stays current with developments in the coding field. Lead duties include assisting with coder selection, onboarding, and training; serving as an initial escalation point for problem accounts and clinician concerns or education needs; conducting and reporting quality audits; monitoring and managing backlog; using Epic reporting for monitoring and process improvement; reviewing failed claims and claim edits for corrections and trends; and liaising with vendors as needed. The Lead escalates employee concerns to the Coding Manager, system issues to the HIM System Analyst, and other concerns to the Coding Manager and/or HIM Director. The position is full time, first shift, with 80 hours per pay period.

Requirements

Coding certification is required, such as Certified Coding Specialist (CCS) or similar.
At least two years of coding experience in a health care setting or equivalent, with experience related to hospital/facility coding.

Nice To Haves

Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT), preferably in combination with coding certification.
Inpatient coding experience.

Responsibilities

Code and audit hospital-based accounts using appropriate coding manuals and/or an encoder, following official coding guidelines and H.I.M. Standards of Conduct.
Enter diagnosis codes, procedure codes, and other required data elements into the computer system for billing and statistical reporting.
Code patient accounts within five days of discharge when the necessary documentation is available.
Monitor the DNFC report daily and code assigned delinquent accounts in a timely manner.
Identify problem accounts through reports and take steps to resolve them, such as addressing no-show patients or account numbers that need to be combined.
Communicate with medical staff when documentation questions affect code assignment and clarification is needed.
Research coding questions using online encoder references and hardcopy reference manuals, and maintain proficiency with current coding developments.
Serve as a resource for business office personnel on account issues or failed claims; work cooperatively and promptly with them to support timely billing.
Assist with selection, onboarding, and training of new coders.
Act as an initial escalation point for problem accounts and clinician concerns or education assistance; escalate employee-related concerns to the Coding Manager.
Conduct coding quality audits and compile findings for the Coding Manager and/or HIM Director.
Monitor and manage coding backlog and use Epic reporting capabilities for process improvement and daily monitoring.
Review failed claims and claim edits for correction and data trending.
Escalate system-related issues to the HIM System Analyst and other concerns to the Coding Manager and/or HIM Director; act as a liaison with vendors as needed.
Demonstrate professional behavior at all times.