Professional Billing Lead Coder (Remote)
Location
United States
Posted
67 days ago
Salary
0
Seniority
Lead
No structured requirement data.
Job Description
Professional Billing Lead Coder (Remote)
University Health
If you are a current University Health or University Health Physicians employee and wish to be considered, you must apply via the internal career site. Please log into myWORKDAY to search for positions and apply. Professional Billing Lead Coder (Remote) 101 Truman Medical Center Job Location Work From Home-City Tax Exempt Lees Summit, Missouri Department Corporate Professional Billing Position Type Full time Work Schedule 7:30AM - 4:00PM Hours Per Week 40 Job Description The coding leads serve as liaisons and leaders between coding staff, the operation, and the Director. The coding leads are recognized as the subject matter experts for coding and for meeting operational objectives. The Lead Coder position is responsible for accurate coding of professional services from medical record documentation. Reviews, codes to complex cases and assigns correct ICD-9/10-CM diagnosis codes and CPT coding, E/M coding and level of interventional and surgical coding. This level will also code for new and experimental treatments and therapies. The lead coders will code for multiple physician specialties. Minimum Requirements - High school diploma or equivalent. - 2 or more coding certifications, i.e. CPC or CPMA, and must maintain active certifications for continued employment - 5 years comprehensive medical record coding, of high level CPT/HCPCs & ICD-9/10, for multi-specialty Physician’s services, including experience in an academic teaching health care organization – candidates with demonstrated abilities/skills at this level without the full years of experience can be considered - Demonstrated ability and experience identifying documentation improvement opportunities - Knowledge of insurance company, third-party and government reimbursement programs; i.e. Medicare, Medicaid, MC+, etc. - Knowledge of medical insurance billing and collection - Extensive knowledge with CPT, ICD 9/10 CD, and HCPCS coding and medical terminology in multiple physician practice specialties - Fluency with Medical terminology, anatomy and physiology - Knowledge of medical information systems for physician billing - Demonstrated proficiency in use of computer hardware and software systems, programs and devices. - Expert level knowledge of Medicare rules and Local Carrier Determination (LCD) and national Correct Coding Initiative (NCCI) edits and proper procedure code sequencing - Competence in physician and staff education, including proficiency in presentation preparation and delivery - Ability to effectively communicate verbally and written with all levels of staff Detail oriented. - Ability to work independently and in a team environment
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SavistaAn end-to-end revenue cycle services provider serving healthcare organizations for over 30 years.
Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE). Job Description The Pro Fee Coder will review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the requirements of hospital data or physician data retrieval for billing and reimbursement. Coder may validate APC calculations to accurately capture the diagnoses/procedures documented in the clinical record for hospitals. The Coder performs documentation review and assessment for accurate abstracting of clinical data to meet regulatory and compliance requirements. Coder may interact with client staff and providers. DUTIES AND RESPONSIBILITIES: Select and sequence ICD-10, and/or CPT/HCPCS codes for designated patient types which may include but not limited to: Ancillary (Diagnostic)/ Recurring; Hospital, Clinic; Physician Pro Fee; Technical Fee or Evaluation and Management, any associated chart capturing with any patient type. Review and analyze facility records to ensure that APC assignments and/or Evaluation and Management codes accurately reflect the diagnoses/procedures documented in the clinical record. Abstract clinical data from the record after documentation review to ensure that it is adequate and appropriate to support diagnoses, procedures and discharge disposition is selected. Complete assigned work functions utilizing appropriate resources. May act as a resource with client staff for data integrity, clarification and assistance in understanding and determining appropriate and compliant coding practices including provider queries. Maintain strict patient and provider confidentiality in compliance with all HIPAA Guidelines. Participate in client and Savista staff meetings, trainings, and conference calls as requested and/or required. Maintain current working knowledge of ICD-10 and/or CPT/HCPCS and coding guidelines, government regulations, protocols and third-party requirements regarding coding and/or billing. Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials. SKILLS AND QUALIFICATIONS: Candidates must successfully pass pre-employment skills assessment. Required: An active AHIMA (American Health Information Association) credential including but not limited to RHIA, RHIT, CCS, CCA, or an active AAPC (American Academy of Professional Coders) credentials COC (formerly CPC-H), CCS-P, or CPC or related specialty credential. Two years of recent and relevant hands-on coding experience Knowledge of medical terminology, anatomy and physiology, pharmacology, pathophysiology, as well as ICD-10 and CPT/HCPCS code sets Ability to consistently code at 95% threshold for quality while maintaining client-specific and/or Savista production and/or quality standards Proficient computer knowledge including MS Office including the ability to enter data, sort and filter excel files, (Outlook, Word, Excel) Must display excellent interpersonal and problem-solving skills with all levels of internal and external customers PREFFERED SKILLS: Recent and relevant experience in an active production coding environment strongly preferred Associates degree in HIM or healthcare-related field, or combination of equivalent education and experience Experience using RCX Cerner, NextGen (a plus) Academic, split-share, and critical care experience Note: Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $22.08 - $34.69 an hour. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills. SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class. California Job Candidate Notice
Why This Role Exists This role requires the next hire to ensure accurate, compliant billing and coding processes that maximize revenue, reduce denials, and accelerate cash flow. What You’ll Be Responsible For - Reviewing and coding medical records accurately (CPT, ICD-10) - Submitting clean claims and resolving denials - Monitoring accounts receivable and following up on unpaid claims - Ensuring compliance with payer and regulatory requirements - Identifying and fixing revenue leakage issues What You’ve Done Before - Managed end-to-end medical billing and coding processes - Reduced claim denials and improved reimbursement rates - Worked with billing systems, clearinghouses, and payer portals - Maintained compliance with HIPAA and billing regulations Who You Are - Detail-obsessed and accuracy-driven - Analytical and solutions-oriented - Proactive in identifying issues and fixing them - Accountable for revenue outcomes, not just task completion What Success Looks Like - 98%+ clean claim rate on first submission - 25%+ reduction in claim denials - 99%+ coding accuracy - 20%+ reduction in days in A/R
Why This Role Exists This role requires the next hire to ensure accurate, compliant billing and coding processes that maximize revenue, reduce denials, and accelerate cash flow. What You’ll Be Responsible For - Reviewing and coding medical records accurately (CPT, ICD-10) - Submitting clean claims and resolving denials - Monitoring accounts receivable and following up on unpaid claims - Ensuring compliance with payer and regulatory requirements - Identifying and fixing revenue leakage issues What You’ve Done Before - Managed end-to-end medical billing and coding processes - Reduced claim denials and improved reimbursement rates - Worked with billing systems, clearinghouses, and payer portals - Maintained compliance with HIPAA and billing regulations Who You Are - Detail-obsessed and accuracy-driven - Analytical and solutions-oriented - Proactive in identifying issues and fixing them - Accountable for revenue outcomes, not just task completion What Success Looks Like - 98%+ clean claim rate on first submission - 25%+ reduction in claim denials - 99%+ coding accuracy - 20%+ reduction in days in A/R
Why This Role Exists This role requires the next hire to ensure accurate, compliant billing and coding processes that maximize revenue, reduce denials, and accelerate cash flow. What You’ll Be Responsible For - Reviewing and coding medical records accurately (CPT, ICD-10) - Submitting clean claims and resolving denials - Monitoring accounts receivable and following up on unpaid claims - Ensuring compliance with payer and regulatory requirements - Identifying and fixing revenue leakage issues What You’ve Done Before - Managed end-to-end medical billing and coding processes - Reduced claim denials and improved reimbursement rates - Worked with billing systems, clearinghouses, and payer portals - Maintained compliance with HIPAA and billing regulations Who You Are - Detail-obsessed and accuracy-driven - Analytical and solutions-oriented - Proactive in identifying issues and fixing them - Accountable for revenue outcomes, not just task completion What Success Looks Like - 98%+ clean claim rate on first submission - 25%+ reduction in claim denials - 99%+ coding accuracy - 20%+ reduction in days in A/R

