Certified Medical Billing Coder Lead - MSO Outsourced
Job Description
Under the direct supervision of the Manager, the Lead Certified Medical Billing Coder, serves as a subject matter expert, providing direction to less experienced staff.
May assist with training, auditing, and / or reviewing productivity and quality rates under the leadership of department management.
Reviews supporting clinical documentation for clinical based services and procedures to ensure accurate code assignment.
The Lead Coder is also responsible for acting as a communication link between a billing office and a care provider's office as well as training providers during their onboarding orientation process.
The Lead Certified medical billing / coder specialist must be skilled in understanding medical terminology and searching the medical providers documentation to identify all diagnoses, conditions, reasons for treatment, services and procedures recorded.
Essential Functions
- Responsible for maintaining coding compliance for multi-specialty clinic.
- Responsible for maintaining current ICD-9, ICD-10, CPT and coding skills.
- Perform internal quality assurance - summarize findings and report these to the Manager.
- Identify areas of coding weakness and develop training plans to address.
- Review / Audit patient disputes surrounding inappropriate coding in a timely manner.
- Review / Audit insurance denials related to coding questions in a timely manner, providing remedy as needed.
- Manage multiple tasks, prioritizing workload in an efficient manner.
- Communicate clearly both verbally and in writing.
- Audit new providers on 100% review for 30-90 day period.
- Audit coding team members productivity
- Ability to train both providers and coders during their onboarding to the organization.
- Maintain an active Certified Professional Coder certification.
- Assist the billing / collection specialists in verifying and correction coding issuers per the insurance request or claim denials.
- Performs other duties as assigned.
Education & Training Requirements
- High School Diploma or equivalent required
- Graduate of an AHIMA or AAPC Certified Coding Program that includes Anatomy and Physiology required
- One or more of the following is required : Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) or Certified Professional Coder Apprentice (CPC-A) (Must have active credential(s) to apply.
Those with a credential or training in progress will not be considered). required
Work Experience Required
- Minimum of three years of related experience in a business, medical or technical environment required
- Previous experience in a medical office setting and / or experience with an Electronic Medical Record preferred
- Certified Risk Coder (CRC) credential and / or knowledge of risk adjustment coding preferred
Benefits
As part of values that Healthcare is a Right and not a Privilege, we offer a suite of benefits
Medical / Vision / Dental (Costs of benefits are based on your yearly salary )
Medical visit copays are waived when seeing a Legacy provider.
9 Holiday + 1 Floating Holiday
403b Retirement Plan
Bright Horizons Back-up Care
As a user of Bright Horizons Back-Up Care, you can conveniently schedule care right from your mobile device with the Back-Up Care app your easy, time-saving solution to managing family care challenges while on the go.
Paid Time Off (PTO)
PTO Exchange benefit
PTO Exchange will provide you with the option to convert a portion of your accrued but unused PTO hours for use toward several different benefits and causes, based on your own priorities.
With PTO Exchange, you can convert a portion of your unused PTO into :
403(b) Retirement contributions
Student loan payments / Tuition for the employee
Leave Sharing donations to fellow employees
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