Lead Hospital Coder | Full Time | Medical Records

Memorial Health Ohio•Paris Township, OH

About The Position

The Lead Hospital Coder 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 HIM Standards of Conduct within the Coding Compliance Plan, supporting quality documentation and accurate reimbursement. The coder selects accurate codes, stays current with developments in the coding field, communicates with medical staff when documentation clarification is needed, and researches coding questions using online encoder references and hardcopy manuals. The position supports business office personnel with account and failed-claim questions, follows up on failed claims to support timely billing, and enters diagnosis codes, procedure codes, and other required data into the computer system for billing and statistical reporting. Patient accounts are to be coded within five days of discharge when the necessary documentation is available. The coder also reviews the daily Discharged Not Final Coded (DNFC) report, codes assigned delinquent accounts, identifies and resolves problem accounts, and seeks assistance from the Coding Manager when needed. Lead responsibilities include helping select, onboard, and train coders; serving as the initial escalation point for problem accounts and clinician concerns or education; conducting coding quality audits and reporting findings to the Coding Manager and/or HIM Director; escalating employee concerns and system issues; monitoring and managing backlog; using Epic reporting for process improvement and daily monitoring; reviewing failed claims and claim edits; and liaising with vendors as necessary. The role requires professional conduct and escalation of concerns to the Coding Manager and/or HIM Director.

Requirements

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

Nice To Haves

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

Responsibilities

Code and audit hospital-based accounts using appropriate coding manuals and/or an encoder.
Follow official AHA and AMA coding guidelines and HIM Standards of Conduct within the Coding Compliance Plan.
Select accurate codes and research coding questions using online encoder references and hardcopy manuals.
Maintain coding proficiency by staying current with developments in the coding field.
Communicate with medical staff when documentation questions affect code assignment and clarification is needed.
Serve as a resource to business office personnel regarding account issues and failed claims.
Work with business office personnel to follow up on failed claims and support timely billing.
Enter diagnosis codes, procedure codes, and other required data into the computer system for billing and statistical reporting.
Code patient accounts within five days of discharge when required documentation is available.
Review the DNFC report daily and code assigned delinquent accounts in a timely manner.
Identify problem accounts and take steps to resolve them; notify the Coding Manager when assistance is needed.
Assist with selection, onboarding, and training of new coders.
Act as the initial escalation point for problem accounts and clinician concerns or education assistance.
Escalate employee-related concerns to the Coding Manager and system-related issues to the HIM System Analyst as necessary.
Conduct coding quality audits, compile findings, and report them to the Coding Manager and/or HIM Director.
Monitor and manage the coding backlog appropriately.
Use Epic reporting capabilities for process improvement initiatives and daily monitoring.
Review failed claims and claim edits for correction and data trending.
Act as a liaison with vendors as necessary.
Demonstrate professional behavior and escalate concerns to the Coding Manager and/or HIM Director.