Lead Professional Coder

Logan Health

7d•$29 - $40•Remote

About The Position

Join our Revenue Integrity team and play a key role in supporting quality patient care through accurate coding, regulatory compliance, and revenue cycle excellence. As a Lead Revenue Integrity Coding Specialist, you'll combine your advanced coding expertise with leadership responsibilities to help ensure accurate reimbursement, mentor team members, and promote continuous quality improvement across the organization. If you enjoy solving complex coding challenges, collaborating across departments, and serving as a trusted resource for your team, we'd love to hear from you.

Requirements

4+ years of coding experience in an acute care or medical office setting.
2+ years of experience utilizing electronic medical record (EMR) systems for data entry and retrieval.
Nationally recognized coding certification required (such as CCS, CPC, or AAPC). Other specialty coding certifications may be considered.
Thorough knowledge of ICD-10-CM, CPT-4, coding guidelines, reimbursement methodologies, and industry best practices.
Strong understanding of anatomy, physiology, medical terminology, health information management, and coding classification systems.
Proficiency with Microsoft Office Suite and the ability to quickly learn additional software applications.
Commitment to maintaining patient confidentiality and compliance with all applicable regulations.
Possess knowledge and understanding of ICD 10 CM, CPT 4 coding guidelines, and practices required.
Minimum of two (2) years’ work-related experience with computer data entry and retrieval skills within an electronic medical record system required.
Must possess ability to learn other software as needed.
Thorough knowledge of classification and nomenclature anatomy, medical terminology, and health information management procedures and practices required.
Excellent organizational skills, detail-oriented, a self-starter, possess critical thinking skills and be able to set priorities and function as part of a team as well as independently.
Commitment to working in a team environment and maintaining confidentiality as needed.
Excellent verbal and written communication skills including the ability to communicate effectively with various audiences.
Excellent interpersonal skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy.
Possess and maintain computer skills to include working knowledge of Microsoft Office Suite and ability to learn other software as needed.
Assigns and sequences ICD 10 CM and CPT 4 codes for all specialty patient types, billing, and reimbursement. These include, but may not be limited to; inpatient, outpatient, ambulatory, and emergency room records.
Accurately codes advanced procedure accounts consisting of numerous components.
Reviews and analyzes medical records for documentation deficiencies.
Accurately reflects the diagnosis and procedures per department procedure.
Reviews charges, ensures accuracy, and checks for medical necessity for ordered tests and/or procedures.
Proactively communicates with appropriate stakeholders to ensure adequate documentation to support services.
Performs timely follow-ups for accounts on hold.
Performs charge capture and data entry per department protocol and procedure.
Accurately abstracts clinical data after documentation assessment and review.
Ensures accurate abstracting of clinical data and meets regulatory and compliance requirements.
Accurately follows coding guidelines and legal requirements to ensure compliance with Federal and State regulatory bodies.
Verifies accuracy of patient account, type, and demographic data.
Coordinates corrections with Patient Access and ensures accurate billing, reimbursement, and reporting.
Meets productivity standards set forth by Revenue Integrity Coding Department.
Exhibits initiative and supports continuous quality improvement efforts.
Successfully participates in continuing education activities to enhance knowledge and skills related to the position.
Maintains regular and consistent attendance as scheduled by department leadership.

Nice To Haves

Previous experience serving as a lead, mentor, trainer, or subject matter expert within a coding or revenue integrity environment.
Experience supporting coding compliance, quality assurance, auditing, or process improvement initiatives.
Experience coding across multiple specialties and patient settings.
Creates work schedule and assigns employees to specific work tasks.
Trains or coordinates the training of employees.
Oversees and coordinates successful completion of employees’ competency assessments and required training.
Acts as point-of-contact/subject matter expert for employee questions about expectations and processes.
Assists in interviewing job candidates.
Leads or coordinates compliance and quality efforts.
Other duties as assigned at the discretion of management, excluding issuing corrective actions or administering performance evaluations

Responsibilities

Assign and sequence ICD-10-CM and CPT-4 codes for a variety of patient encounters, including inpatient, outpatient, ambulatory, and emergency department records.
Accurately code advanced and complex procedural accounts with multiple components.
Review medical records for documentation deficiencies and ensure diagnoses and procedures are accurately reflected according to coding guidelines.
Review charges for accuracy, verify medical necessity, and collaborate with providers and departments to obtain complete supporting documentation.
Perform timely follow-up on accounts requiring additional documentation or clarification.
Complete charge capture, data entry, and clinical data abstraction while ensuring regulatory, compliance, and reporting requirements are met.
Verify patient account information, encounter types, and demographic data while coordinating corrections with Patient Access when needed.
Maintain compliance with all federal, state, and organizational coding standards and regulations.
Meet established productivity and quality benchmarks while maintaining a high level of coding accuracy.
Participate in continuing education and stay current on coding guidelines, regulations, and industry best practices.
Support departmental quality improvement initiatives and identify opportunities for process enhancement.
Create work schedules and assign daily work responsibilities.
Train, mentor, and support new and existing team members.
Coordinate competency assessments and required employee training.
Serve as a subject matter expert and primary resource for coding questions and workflow guidance.
Assist with interviewing and onboarding new employees.
Lead or coordinate coding compliance, auditing, and quality improvement initiatives.
Perform additional leadership-related responsibilities as assigned by management.