Physician Billing Coding Lead

Lurie Children's Hospital•Chicago, IL

1d•Onsite

About The Position

The Pro-Fee Coding Lead will be responsible for reviewing medical documentation and assigning CPT and ICD-10 for various departments of the organization. The Pro-Fee Coding Lead will work collaboratively with the Coding Manager, Physician Billing to maintain day-to-day coding operations and various projects and duties assigned.

Requirements

Minimum Of Associate Degree is Required.
High School Diploma required.
Coding credentials required such as RHIT, RHIA, CPC, CCS-P and other surgical coding credentials.
Requires 3-5 years coding work experience.
Demonstrates thorough knowledge of CPT and ICD-10-CM coding.
Maintains a thorough understanding for medical record practices, standards, regulations, Joint Commision on Accreditation of Health Organizations (JCAHO) and Illinois Medicaid coding and reporting requirements.
Demonstrates understanding of medical terminology, anatomy and physiology and coding classification systems and is able to apply this knowledge in determining appropriate physician coding.
Demonstrates the ability to communicate effectively with providers, co-workers and managers.
Demonstrates the ability to work independently and balance multiple priorities.
Demonstrates the ability to use multiple types of computer software (i.e., Word, Excel, EPIC, 3M, SharePoint, etc.).

Nice To Haves

Working and performance knowledge for divisions within the assigned coverage area preferred
Management and Project Management preferred

Responsibilities

Performs coding functions as needed for Lurie/Outreach Locations.
Monitors coder’s productivity by collaborating with Coding Manager to meet designated productivity and quality benchmarks.
Resolves questions, issues and patient disputes with third party payors, billing coordinators, compliance auditors, external billing company and denial management team that pertain to coding.
Prepares department coding feedback materials based on trends and issues identified via Coding WQ’s and coding denial trends.
Works with Coders and Audit Manager to resolve denials, identify trends and implement process improvements to increase clean claim rate and improve denial recovery rate.
Collaborates with Coding Manager to improve Charge Review Work queues workflow thru various WQ improvement initiatives.
Collaborates with Coding Manager regarding content for Coders Monthly Meeting including preparing education materials, room reservation and other tasks requirements.
Collaborates with Coding manager to perform and complete revenue cycle coding projects
Develops and maintains division specific coding protocols.
Assists Coding Manager with employee time management on a weekly basis including staffing coverage.
Assigns appropriate ICD-10-CM diagnosis code(s), CPT procedure codes and modifiers using coding conventions, guidelines and payor specific requirements.
Abstract and compile data from medical records for appropriate optimal reimbursement.
Works actively with physicians to initiate corrections and resolve discrepancies in coding and documentation.
Works collaboratively with physicians to assure accurate and timely submission of claims.
Provides feedback at division meeting around documentation and coding.
Submits help desk tickets and CIS for coding and collaborates with IM for resolution.
Collaborates with Coding Manager on month end close numbers for coding.
Provides regular communication and education to providers and other clinical teams as indicated.
Acts in the capacity of liaison to providers, managers and other coding team members.
Ensures that all charges are submitted accurately and in a timely manner.
Works collaboratively with Compliance Auditors to identify trends, billing opportunities and physician education needs.
Performs job functions adhering to service principles with customer service focus of innovation, service excellence and teamwork to provide the highest quality care and service to our patients, families, co-workers and others.
Performs other related duties as assigned.

Benefits

Medical, dental and vision insurance
Employer paid group term life and disability
Employer contribution toward Health Savings Account
Flexible Spending Accounts
Paid Time Off (PTO), Paid Holidays and Paid Parental Leave
403(b) with a 5% employer match
Supplemental Life, AD&D and Disability
Critical Illness, Accident and Hospital Indemnity coverage
Tuition assistance
Student loan servicing and support
Adoption benefits
Backup Childcare and Eldercare
Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members
Discount on services at Lurie Children’s facilities
Discount purchasing program