HIM Coder Lead - Outpatient
CHRISTUS Trinity Clinic
500 E Murchsion
Palestine, TX 75801
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Selected by CHRISTUS Health Coding Leadership, to focus coding skills and expertise to foster an environment of teamwork and service excellence mentoring, training, cross training their designated Regional Inpatient or Outpatient Coding team. Coding Lead will work with Coders as a resource to maintaining current and high-quality ICD-10-CM, ICD-10-PCS and/or CPT coding for the Inpatient and or/ Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. Coding Leads will work to ensure Coders abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM and ICD-10-PCS Guidelines for Coding and Reporting and AMA CPT Guidelines. Coding Lead will act as a liaison for coding related questions, providing clear and concise written or verbal responses, citing official coding guidelines and Coding Clinics.
Coding Lead will work to resolve errors reports associated with billing process, identify and report error patterns, and, when necessary, assist in performance improvement activities with other team associates.
Coding Lead will work collaboratively with various CHRISTUS Health departments, included but not limited to HIM and Clinical Documentation Specialists, to ensure accurate and complete physician documentation to support accurate billing and reduce denials. Coder will also assist in other areas of the department, as requested by leadership.
Coding Lead will report directly to their Regional Coding Manager, with additional leadership from the Director of Coding Operations and System HIM Director.
- Maintain standardized, organization-wide policies and procedures to monitor the success and quality of coding.
- Will review internal and external audit results, to identify global and individual areas for improvement.
- Coach coding associates based upon internal and external audit results, or based upon coding needs.
- Actively collaborate with Unbilled Analysts to complete billing workflow changes to reduce billing errors.
- Manage and work billing reports, such as Connance, to provide timely corrections to accounts in questions, ensuring billing is not impacted.
- Assists in implementing new systems and/or processes, to improve back-end billing errors.
- Acts as coding liaison, proving expertise in coding, charging, DRG assignments, APC assignments, modifier application, special projects and denials.
- Analyzes audit results to identify areas of opportunity.
- Assign codes for diagnoses, treatments and procedures according to the ICD-10-CM/PCS Official Guidelines for Coding and Reporting through review of coding critical documentation, to generate appropriate MS/APR DRG.
- Abstracts required information from source documentation, to be entered into appropriate CHRISTUS Health electronic medical record system.
- Validates admit orders and discharge dispositions.
- Works from assigned coding queue, completing and re-assigning accounts correctly.
- Manages accounts on ABS Hold, finalizing accounts when corrections have been made, in a timely manner.
- Meets or exceeds an accuracy rate of 95%.
- Meets or exceeds the designated CHRISTUS Health Productivity standard per chart type.
- Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA).
- Assists in implementing solutions to reduce backend-errors.
- Identifies and appropriately reports all hospital-acquired conditions (HAC).
- Expertly queries providers for missing or unclear documentation, by working with the HIM department and Clinical Documentation Improvement Specialists.
- Participates in both internal and external audit discussions.
- All other work duties as assigned by Manager
A. Education/ Skills
- High school Diploma or GED
- Completion of Accredited Baccalaureate Health Informatics or Health Information Management or an AHIMA approved Coding Certificate Program, preferred.
- Strong written and verbal communication skills.
- Able to work independently in a remote setting, with little supervision.
- Minimum of five(5) years of Inpatient and/or Outpatient coding experience in an acute care setting
C. License, Registrations, or Certifications
- Registered Health Information Administrator (RHIA) (AHIMA)
- Registered Health Information Technician (RHIT) (AHIMA)
- Certified Coding Specialist (CCS) (AHIMA)
- Certified Professional Coder (CPC) (AAPC)
- Certified Interventional Radiology and Cardiovascular Coder (CIRCC) (AAPC)