Physician Billing Coding Lead

Ann & Robert H. Lurie Children's Hospital of ChicagoChicago, IL
Onsite

About The Position

The Pro-Fee Coding Lead will be responsible for reviewing medical documentation and assigning CPT and ICD-10 for various department 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
  • Various voluntary benefits: 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

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Education Level

Associate degree

Number of Employees

1,001-5,000 employees

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