Outpatient Coding Team Lead

Job Description

Under direct supervision, the Outpatient Coding Team Lead, provides day to day supervision and instruction for the coders.

The Outpatient Coding Team Lead oversees specific hospital outpatient accounts based on acuity for the purpose of appropriate reimbursement, research, statistics and compliance to federal and state regulations in accordance with established ICD-10-CM and CPT-4coding classification systems.

The Outpatient Coding Team Lead assists in resolving interdepartmental coding inquiries and communicates with various departments within the hospitals regarding billing and registration issues.

The Outpatient Coding Team Lead must also have an advanced recent hands on knowledge of Claim Edit functionalities to include NCCI edits, NCD & LCD requirements, payer guidelines and medical necessity.

• The Outpatient Coding Team Lead must possess expert knowledge in the assigning of ICD-10 diagnoses, CPT-4 procedure coding and appropriate modifiers derived from medical record documentation for complex and multi-specialties that include Claim Edit accounts, ED, Clinics, Recurring / Series encounters, Surgeries, Observation, Interventional Radiology (IR) & Cardiology.
• Provides coding support as needed for ICD-10 diagnostic codes and CPT-4 procedure codes to outpatient, ambulatory surgery, and observation visits for the purpose of reimbursement, research and compliance with federal and state regulations.

Provides day to day instruction for the coders, which includes WQ monitoring, problem solving, monitoring productivity, scheduling, training, and enterprise testing.

• Provides backup coding support for outpatient coding as needed.
• Monitors coder’s assigned work on a daily basis in order to facilitate the billing process within the established timeframes.
• Communicates staffing shortages for associated workload.
• Monitors bill holds to maintain financial stability of organization.

Qualifications

• Associates degrees or total of 6 years’ experience.
• 4 years’ experience with coding outpatient hospital medical records.
• One of the following : Certified Coding Specialist (CCS), Certified Professional Coder (CPC).
• Bachelor’s degree in related field preferred
• Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA).

Additional Information

All your information will be kept confidential according to EEO guidelines.