Lead Coder-Professional Services WMCG

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Various (United States of America)

The Lead Coder-Professional Services assists in the day‑to‑day operation of the department, in addition to performing front line coding for either the Non‑Surgical or Surgical Coding section within the Professional Services Coding and Compliance Department. This includes coordinating schedules and distributing work for up to 26 professional coders who work on site and remotely. This position serves as a resource for front line coders specifically related to operations issues, including being a superuser for coding applications.

• Develops and maintains a detailed understanding of the complete billing process to include both the technical and professional component.
• Maintains working knowledge of GE Healthcare (IDX), Healthquest, and Cerner Power chart.
• Assists the Coding Education Specialist with conducting quality audits of coded services by the coding staff.
• Ensures staff is coding properly and maintaining industry standard productivity.
• Assists with developing and maintaining departmental policies and procedures.
• Assists in training all incoming coding staff as well as assists staff with coding questions when guidance is needed.
• Provides monthly feedback to Coding Education Specialist regarding coding staff accuracy, productivity, and coding/educational needs.
• Manages and maintains coding review backlog and work files to within 3 days of documentation completion.
• Assists in the review and analysis of the documentation and coding patterns of providers.
• Updates billing forms timely with all current code sets for CPT, HCPCS, and ICD‑10.
• Maintains current billing requirements of all carriers to determine when a service is billable and how it should be billed appropriately for maximum reimbursement.
• Maintains a close working relationship with the Revenue Cycle Management Team.
• Assists with identifying billing concerns that must be corrected and reported to the AU Medical Associates Compliance Office.
• Analyzes available monthly denial reports.
• On a monthly basis, trends performance of the various billing areas and presents results to Coding Education Specialist.
• Assists Coding Education Specialist with providing denial trends to Physicians.
• Maintains industry standard compliant coding and billing knowledge to include federal and state regulations.
• Assists the Coding Education Specialist with disseminating information to staff.
• Performs other duties as assigned.
• Complies with all Wellstar Health System policies, standards of work, and code of conduct.

• High School Diploma General or GED General or Bachelors Health Information Management-Preferred

• CPC - Cert Prof Coder or CCS - Cert Coding Spec or RHIA - Reg Health Information Admin or RHIT - Reg Health Information Tech

CPB and CPMA through AAPC within 1 Year Preferred

Minimum 4 years Interventional and Surgical procedures related experience. Required and

• Previous third-party reimbursement experience
• High Proven experience with coding and medical terminology
• High Knowledge of state and federal laws pertaining to the billing and collection of patient accounts
• High Must have ability to handle multiple projects, meet deadlines, and assign priorities
• High

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