Billing Coder Team Lead - Anatomical Pathology

Job Details

• Level: Experienced
• Job Location: IDX Coppell TX Site - Coppell, TX
• Position Type: Full Time
• Education Level: High School
• Job Category: Biotech

Inform Diagnostics, a Fulgent Genetics Company, is a nationally recognized diagnostics laboratory focused on anatomic pathology subspecialties including gastrointestinal pathology, dermatopathology, urologic pathology, hematopathology, and breast pathology.

Founded in 2011, our parent entity, Fulgent Genetics, has evolved into a premier, full-service genomic testing company built around a foundational technology platform.

Through our diverse testing menu, Fulgent is focused on transforming patient care in oncology, anatomic pathology, infectious and rare diseases, and reproductive health. We believe that by providing a wide range of effective, flexible testing options in conjunction with best-in-class service and support, we can redefine the way medicine is managed for patients and clinicians alike.

Since integrating with our therapeutic development business, Fulgent is also developing drug candidates for treating a broad range of cancers using a novel nanoencapsulation and targeted therapy platform. By merging our fields of expertise, we aim to become a fully integrated precision medicine company.

Coding Team Leads are responsible for performing quality reviews and generating departmental reports on the performance of the department to ensure the department maintains high standards of quality and compliance. This position works in a computer‑based billing software program and requires expert knowledge of all insurance types for all regions billed. Billing and coding subject matter expert (SME) supporting assigned Hematopathology and Anatomic Pathology billing and coding team.

• Conducts information reviews and evaluates results comparing the requisition demographics and insurance information to the information that was entered into the billing system during the data entry process.
• Maintains QA at or above required 95% accuracy and performs additional training with individuals that fall below the standard to ensure the success of the team as a whole.
• Identifies and documents errors found in the data entry process using insurance guidelines and departmental procedures. Provides follow‑up and training to individuals as needed.
• Reconciles Novo Path/Quadax file transmissions to ensure timely filing of cases.
• Maintains and reports department quality/productivity data monthly for the team.
• Downloads files from the billing system, imports data into Excel and creates worklists/assignments.
• Monitors denials for trends and evaluates processes that can be updated to ensure clean claims are sent out.
• Develops training documents and SOPs for the department.
• Reports to Senior Manager any deficiencies identified that affect TAT for case release to billing, denial trends, etc.
• Updates LCD/NCD requirements as released by MCR each year. Provides education to the team regarding any changes that affect the coding department as a whole.
• Accepts other duties as assigned.

• Maintain current knowledge of Current Procedural Terminology (CPT) and International Classification of Diseases (ICD‑10) codes to ensure reliable communication with all physicians and coworkers and other healthcare providers and insurance carrier billing requirements.
• Proficient in 10 key and alpha‑numeric data entry.
• Proficient in Microsoft Office Suite, specifically Word, Excel, Outlook, and general working knowledge of Internet for business use.
• Ability to work in a fast‑paced, deadline‑driven environment.
• Drive for Results (Service, Quality, and Continuous Improvement) – Ensure procedures and processes are in place that will lead to delivery of quality results and continually reassess their effectiveness to achieve continuous improvement.
• Communication – Proficient verbal and written communication skills. Ability to share and receive information and ideas from all levels of the organization in order to achieve the desired billing and coding results.
• Teamwork – Commitment to the successful achievement of team and organizational goals through…