Professional Fee Coding Quality Lead

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaborating with top clinical, technical, and business professionals across all disciplines.

Entity: Corporate Services
Department: Central Fee Abstract Corp
Location: 150 Monument Blvd
Hours: Hybrid, Monday‑Friday, daylight (team usually starts between 5 am and 6:30 am but has some flexibility with manager approval)

• Validate that the appropriate ICD‑10‑CM diagnosis codes have been assigned in accordance with coding guidelines.
• Validate that appropriate CPT‑4 codes for evaluation and management services and/or specified inpatient procedures have been assigned.
• Participate in the training process of new staff members, internal and external contract employees.
• Assign ICD‑10‑CM and CPT‑4 codes to operative notes; review entire operative notes, capture all codes, eliminate codes based on the Correct Coding Initiative edits, attach modifiers to ensure accurate payment, and contact physicians when clarification is necessary.
• Assist with the coding of all clinical services, both Evaluation and Management services and operative procedures, if needed for coverage purposes.
• Identify coding variances when the physician codes his/her own services.
• Identify unbillable events by the rendering or requesting physician.
• Neatly and accurately complete a daily production log.
• Perform other duties as dictated by the Director or Manager.
• Assist with the expansion of professional fee coding to other hospitals in the Health System, investigating physicians and billing practices, and communicating findings to the outside vendor. Perform quality checks during “go live.”
• Participate regularly in calls with the outside vendor to ensure proper training and quality of the professional fee coding staff.
• Prepare for, participate in, and follow up after meetings with Clinical Departments, Finance, Compliance, Physicians, etc.
• Perform duties in accordance with Penn Medicine and entity values, policies, and procedures.
• Other duties as assigned to support the unit, department, entity, and health system organization.

• Associate’s Degree and 7+ years experience coding and auditing inpatient and outpatient medical records.
• or Bachelor's Degree in Nursing, Health Information Management or related field and 5+ years experience coding and auditing inpatient and outpatient medical records.
• or Master’s Degree program track in Nursing, Health Information Management or related field with 0–1 year experience coding and auditing inpatient and outpatient medical records, plus 5 years extensive knowledge of complex coding in a large academic medical center.

• Certified Professional Coder – CPC (AAPC) or CCS‑P (AHIMA)

• Understanding of electronic medical records functionality.
• Demonstrated interpersonal/verbal communication skills.
• Extensive knowledge of ICD‑10‑CM and CPT‑4 codes; proficiency with evaluation, management, and procedure coding required.
• Extensive knowledge of federal, state, and third‑party payer inpatient documentation requirements.
• Ability to perform work independently and make judgment calls without close oversight.
• Understanding of electronic audit tool use and capabilities.

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region.

We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.

Mid‑Senior level

Full‑time

Accounting/Auditing

Wellness and Fitness Services, Hospitals and Health Care, Medical Practices