Coding Team Lead - Revenue Cycle

Assists in the coordination of daily coding workflows and activities amongst CMC's facility coders to maximize efficiencies and reimbursement opportunities. Assists in providing mentorship, ongoing training, education, auditing, and support of all facility coders at Catholic Medical Center.

PRINCIPALDUTIES AND RESPONSIBILITIES:

Under the general direction of the Executive Director of Revenue Cycle, and the direct guidance of the Facility Coding Manager and within established policies and procedures, the incumbent performs the following functions:

  1. Collaborates with the Facility Coding Manager on interviewing, selection and the orientation process for all facility coder candidates and hires within CMC.
  2. Ensures regulatory compliance by remaining up-to-date with federal and state coding regulations. Shares this knowledge with management and all coders in order to collaboratively incorporate necessary changes to processes to achieve adherence to regulations


3. Collaborates with management to develop educational programming for facility coders while simultaneously motivating them to retain a high degree of coding accuracy.

4. Participates in periodic coding and documentation audits (both internal and external) for accuracy and compliance, and uses the results to identify trends or variances in coding that require additional training to correct and eliminate.

5. Stays current on any regulations or processes related to the implementation of ICD-10 specific training and shares this knowledge with all coders.

6. Monitors work queue volumes and ensures accurate and timely coding of all hospital encounters according to established timeframes, policies, and procedures. Maintains their own coding work queue accurately and timely

7. Collaborates with the Coding Manager to coordinate coding of both inpatient and outpatient services by adjusting staff patterns and workflows as needed to ensure timely coding of all services at CMC

8. With the direction of the Facility Coding Manager, or in thE1ir absence, assists with facilitating the department's necessary reports as well as all activities involved with the month end closing of accounts.

9. Provides recommendations to management about potential workflow improvements and adjustments to processes, policies, or procedures o increase efficiency and accuracy of coding practices.

10. Collaborates with the IS department for all software updates related to coding for hospital encounters.

11. Takes an active role in project or process implementation and monitors staff compliance and achievement of related goals.

12. Provides feedback as appropriate on overall performance and work ethic of hospital coding staff as well as addresses posed questions or concerns from coders, clinicians, or other related departments.

13. Maintains established policies and procedures, objectives, quality assessment and safety standards.

14. Collaborates with the Revenue Cycle Nurse Auditor as well as the billing office to review coding denials and billing edits to prevent future denials and lost revenue.

15. Provides outstanding services to all customers, fosters teamwork; and practices fiscal responsibility through improvement and innovation.

16. Reviews clinical documentation in order to assign diagnostic and procedural codes for inpatient and outpatient medical records according to the appropriate classification system

17. Ensures accurate, timely, and appropriate assignment of ICD-10, CPT/HCPCS, and APC codes for the purposes of billing, internal and external reporting, research, and compliance with regulatory and payer guidelines.

18. Acts as a liaison for coding to ancillary departments, administration, and physicians by answering questions or providing support and attending meetings as issues arise.

19. Abides by the standards of ethical coding and adheres to official coding guidelines.

Education:

• Formal coursework in ICD and CPT coding and medical terminology

Experience:

• 5 or more years of outpatient and inpatient combined coding experience

• Current status of a Facility Coder Ill within the department

• Working knowledge of ICD and CPT coding classification systems; coding for third party payers, including CMS guidelines and reimbursement compliance; HIPAA, JCAHO, and other compliance requirements

• Must have excellent communication, project management, team building, and leadership skills.

• Excel and Word experience

Licensure/Certification:

• Coding Certification required, such as a CCS, CIC, COC