Physician Billing Coding Lead

Ann & Robert H. Lurie Children’s Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H.

Lurie Children’s Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report.
** Location
* * 680 Lake Shore Drive
** Job Description
***
* Summary:

** 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.
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* Essential Job Functions:

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* • 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.
** Knowledge, Skills, and Abilities:*
* • 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.  
• Working and performance knowledge for divisions within the assigned coverage area preferred  
• Management and Project Management preferred  
• 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.  
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