Coder - Clinic, Patient Financial Services

Join to apply for the Coder 2 - Clinic, Patient Financial Services role at Our Lady of the Lake Health
.

To review and audit Network Provider medical records for documentation and coding compliance and quality with federal and state laws and regulations.

• Quality and Performance Improvement: research, develop, and implement standardized processes for quality monitoring of inpatient and outpatient coding and abstracting. Conduct quality audits for coding according to pre‑established criteria in coordination with the Coding and Reimbursement Specialist. Assist Management with evaluation of functions and processes of the coding area to determine opportunities to improve efficiency and quality. Implement innovative ideas and process changes.
• Attend meetings as required and strive to improve the quality of meetings by taking an active role in meeting topics. Participate in educational programs, in‑services, and training sessions to share expertise with others and further education and personal growth for new personnel, volunteers, and interns.
• Collaboration and Partnership: establish and maintain interdepartmental relationships with Network providers to facilitate cooperation and compliance. Assist the Physician Network, Revenue Management Department and other financial departments with clarification of coding regarding reimbursement issues to resolve claim edits and assure clean claim submission. Monitor and evaluate compliance with documentation standards to identify trends, issues, risk areas, and opportunities for education and process improvement.
• Collaborate with Management to identify and coordinate educational needs based on audit results and new technologies. Provide support to the Coding and Reimbursement Specialist with monthly statistics and educational programs for staff. Provide technical assistance to the Systems Specialist for authorized coding database retrieval and resolution of software and system functionality.
• Other Duties As Assigned: perform other duties as assigned or requested.

• Associate’s degree, Bachelor’s degree, or coding certification (CCS or CPC) with 3 years of experience, OR 5 years of experience in medical coding without a degree or certification.
• Thorough knowledge of medical terminology, managed care financial agreements.
• Thorough knowledge of CPT-4, HCPC, and ICD-9 codes.

Mid‑senior level

Full‑time

Health Care Provider

Hospitals and Health Care