Profee Coding Lead

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format.

Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care.

By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare.

A Profee Coding Lead with a strong Ortho background with a focus on spinal procedures. The ideal candidate will monitor and report work queue volumes, work coding queries from physicians, billing, coding and practice staff on a daily basis. Candidate will also be required to monitor a missing operative report and be able to effectively communicate information from client to coding team effectively.

• Review medical record documentation to identify pertinent diagnoses/procedures requiring code assignment for profee charts and accurately code the diagnoses and procedures for reimbursement, research, and compliance with federal regulations.

• Query physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes.

• Keep abreast of coding guidelines and reimbursement reporting guidelines, bringing identified concerns to the manager for resolution.

• Mentor and train newly hired coders and providers, providing ongoing training for coding staff.

• Assist the coding manager with special coding assignments or coding tasks to resolve unbilled issues.

• Serve as a resource for all coding-related questions, responding promptly to requests and questions from coding staff.

• Promote individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.

• Monitor and report all required performance measures, including the development of department goals and assistance in assessing goal attainment.

• Conduct and recommend training to improve team performance.

• Ensure management is informed of any employee personnel issues.

• Function as a resource to employees for questions and additional training.

• Assist management in monitoring staff's KPIs, timekeeping, and schedules.

• 3+ years of Profee coding experience

• Previous supervisory/team lead experience

• Coding Certification from the American Association of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA) required

• High School Diploma or GED required

• Associates Degree in Health Information Management or any Healthcare Related Field preferred

• Proficient knowledge of ICD-10 and Profee coding guidelines

• Strong billing/denial experience

• Effective oral and written communication skills

• Strong analytical skills to interpret data

• In-depth knowledge of human anatomy, medical terminology, and surgical terminology

• Strong critical thinking skills and decision-making abilities

• Comprehensive understanding of coding compliance policies, coding guidelines for multiple specialties, and insurance payor policies

• Auditing experience

• Education/Training experience

• Full Benefits including a 401k Savings Plan

• Access to 20-24 free CEUs per year, provided by Datavant, to support your continuous professional development

• Compensation for AAPC/AHIMA dues

• Company-provided equipment including computer, monitor, mouse, etc

• Comprehensive training led by a credentialed professional coding manager

• Exceptional service-style management and mentorship (we’re in this together!)

To ensure the safety of patients…