Coder Lead - Allergy and Asthma Center of NC - High Point

Coder Lead - Allergy and Asthma Center of NC - High Point

ID 2024-26061

Location

Allergy and Asthma Center of NC - High Point

Work Location

US-NC-High Point

Division : Name

Cone Health Medical Group

Department : Name

AAA-ALLERGY AND ASTHMA HIGH PT

Category

CLERICAL / ADMIN

Position Sub-Category

INSURANCE / BILLING

Position Type

Full Time (40 hours / week)

Employment Type

Employee

Exempt / NonExempt

Non-Exempt

1.00

Workforce Status

Hybrid I

Work Hours

40.00

Provider Schedule (specific schedule)

On call Required

Sub Category

Insurance / Billing

Overview

Responsible for accurate coding and abstracting of medical information for billing and statistical purposes, and entering the information into a computerized database.

Provides oversight and leadership for the CHCC coding staff.

Talent Pool : Corporate Services / Professional

Responsibilities

Productivity metrics for coding system-based inpatient and outpatient charges, including manual submissions, are consistently met based on departmental standards.

Reviews clinical documentation to ensure that diagnosis codes assigned are accurate and makes changes as necessary. Maintains a quality metric of 96%.

CPT / HCPCS Coding Accuracy : (a) Reviews evaluation and management codes captured by physicians to insure the codes are consistent with the clinical documentation.

Uses the palmetto GBA E&M Review Checklist and Scoresheet Form to validate code capture of office visits. Makes changes as necessary.

b) Reviews charge capture of chemo services (i.e. drugs and administration) and other ancillary services (i.e. blood transfusions, etc.

for accuracy and makes changes as necessary. Translates medication dosages into billing units (quantity). Maintains a quality metric of 96%.

Follows up with clinical staff for missing documentation or clarification of charges (i.e. missing dictation, missing charges, etc.

Maintains a positive and open line of communication with clinical staff.

Performs assigned duties based on departmental guidelines. Daily export; assigns PD modifier as applicable per review of the census report;

review Clinical Research Patient List to ensure clinical trial drugs are not billed.

Stays current with coding policies and applies them to daily tasks. Uses reference tools to insure coding accuracy (3M, CodeCorrect, ICD-9 / CPT / HCPCS manuals, etc.

Notifies management as necessary for needed coding updates to the system.

Provides guidance, leadership and oversight to the oncology coding team. Reviews the team's work, provides timely feedback, assigns work, and develops reports.

Provides input into performance evaluations and holds team accountable to performance goals and Cone Health values.

Qualifications

EDUCATION :

High School Diploma or equivalent, Required

Associates, Healthcare Related Field, Preferred

Required :

• Completion of a formal course of study in medical terminology, disease processes, anatomy, and physiology.
• Completion of a formal course of study in medical coding, billing and regulatory compliance.

EXPERIENCE :

2 - 4 Years, Related Experience, Required

4+ Years, Related Experience, Preferred

LICENSURE / CERTIFICATION / REGISTRY / LISTING :

REQUIRED :

At least one of the following credentials is required :

AHIMA - RHIA, RHIT, CCS or CCS-P

AAPC - CPC, COC, CIC, CHONC or CEMC

PREFERRED :

AHIMA - RHIA or RHIT plus one of the following :

AHIMA - CCS, CCS-P

AAPC - CPC, COC, CIC, CHONC or CEMC