Lead Coder

The Lead Coder provides on-going coder and provider education, communicates with coders and providers regarding new coding policies and trends, and aligns with providers to secure accurate and timely dictation for effective coding. The Lead Coder is the subject matter expert for their team, and establishes partnerships with physicians, as well as with the Reimbursement, Denial and Billing Departments. The Lead Coder also codes in the medical service area.

Essential Job Functions

Utilizes the electronic medical record to code diseases, procedures, and operations with the current diagnosis and procedure classifications for both professional and facility services.

Accesses designated resources such as coding initiatives, local medical review policies, HCPCS, Coders Desk Reference, etc. to research appropriate codes for adherence with coding guidelines.

Partners with providers for quality, optimum coding by engaging in on-going feedback on updated coding criteria and guidelines.

Communicates current procedure and diagnosis coding guidelines with providers. Serves as a resource regarding documentation and coding issues.

Assists Business Office staff in the resolution of coding related denials guidelines and take corrective action for claim resubmission for reimbursement.

Monitors daily activity reports to assure all encounters are being coded and submitted for billing.

Performs documentation review and audits to validate coding. Works with physicians and leaders to interpret coding data reports and trends.

Provides on-going coder and provider education and communicates with coders and providers regarding new coding policies and trends to align with providers secure, accurate, and timely dictation for effective coding.

Acts as a primary resource to providers regarding all documentation and coding issues and establishes partnerships with physicians as well as the Reimbursement, Denial, and Billing Departments.

Performs other duties as assigned or needed to meet the needs of the department/organization.

Requirements:
Certified as = Certified Coding Associate, Certified Coding Specialist, Certified Coding Specialist - Physician Based, Certified Professional Coder - Hospital Outpatient, Certified Professional Coder, or Registered Health Information Technician; minimum of 3 years related experience.