Team Lead Coder Coding Validation

Cotiviti

19h

About The Position

The Team Lead Coder Coding Validation position will have responsibility for supervising a team of Coding Validation analysts or coders. Team Leaders ensure that the work of others meets productivity standards, quality and client guidelines. Primary responsibilities include queue management, work distribution, performance and production optimization, audit planning, coder interactions, training of new hires/existing staff, on appeals support while meeting SLA obligations. The Team Lead goal is to ensure the team audits client data on behalf of our clients, generating high quality payment determinations and displays professional skepticism that enhances the work performed in order to achieve success in position.

Requirements

• Coding certificate required i.e. CCDS, CPC, CIC, CCS, RHIA or RHIT
• 3 to 5+ years of knowledge of healthcare claims payment policy and processing including Professional, Multispecialty and specifically CMS, Medicaid regulations, AAOS, ICD-10, CPT and HCPCS, etc. coding guidelines.
• Proficient in Microsoft Office suite and system databases.
• Ability to adapt to a changing workplace. Able to work in a fast-paced environment and must be adaptable with analytical and problem-solving skills
• Excellent written and verbal communication skills. An ability to think logically and process sequentially with a high level of detailed accuracy and efficiency.
• Self-motivated to exceed the customer’s goal of service while leading a successful team.
• Ability to work well in an individual and team environment
• Upholding ethical standards and integrity.
• Communicating with others to exchange information.
• Problem-solving and thinking critically.
• Effective communication skills.
• Making timely decisions in the context of a workflow.
• Remembering and adhering to processes and protocols.
• Applying established protocols in a timely manner.
• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Repeating motions that may include the wrists, hands and/or fingers.
• No adverse environmental conditions expected.
• Must be able to provide a dedicated, secure work area.
• Must be able to provide high-speed internet access / connectivity and office setup and maintenance.

Nice To Haves

• Bachelor’s degree in nursing or other health or informatics field preferred
• Prior management or supervisory experience preferred.

Responsibilities

• Appeals: Oversee onshore/offshore Coder Coding Validation team(s) in reviewing claims and producing well written appeals consistent with high level of integrity and meeting metrics
• Provides support needed to review quality claims and appeal, utilizing nationally recognized coding standards, and proprietary coding validation guidelines and client specific guidelines (for specified teams)
• Team Coordination. Primarily responsible for optimization of the team and individual coder performance, including production, accuracy and quality. Responsible for handling the production training, development and process improvements in working in conjunction with the team.
• Work with Quality Assurance to ensure analysts or coders are meeting quality execution of CV audit deliverables.
• Handles employee reviews, new hire on- boarding, PTO, coaching and mentoring, monitors staff productivity.
• Serves as a resource for the analyst or coders in terms of questions related to specific claims and clinical industry standards.
• Creates an environment that fosters information sharing. Collaborate with Manager and Human Resources in applying best practices to areas of Employee Relations and performance management.
• Ensures all Cotiviti and department rules and processes are followed. Actively recommend system or process improvements or enhancements that will increase productivity, quality or cost containment.
• Oversight of Service Delivery. Ensure operational controls and day-to-day processes are in place. Distributes work among analysts or coders - ensuring timely submission and responding to all client requirements/inquiries swiftly and professionally. Utilizes various proprietary reports and systems provided. Ensure teams are meeting KPI metric expectations including client SLAs and quality standards. Ensure team timecards are reviewed and corrected as needed. Ensures alignment between strategic goal setting process and performance management process to ensure the organization has the depth and breadth of talent to achieve organizational goals.
• Hire, develop, coach, lead and retain top-tier talent, with a focus on building and improving a team and culture that can assist in employing best in class practices to support and drive high levels of internal and external customer satisfaction.
• Complete all responsibilities as outlined in the annual performance review and/or goal setting.
• Complete all special projects and other duties as assigned.
• Must be able to perform duties with or without reasonable accommodation.

Benefits

• Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(K) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees