What are the responsibilities and job description for the OUTPATIENT CODER LEAD (OCCASIONAL ONSITE REQUIRED) position at Covenant HealthCare?
Overview
The Health Information Management Outpatient Coding Specialist Lead provides timely and accurate clinical and administration data to ensure optimal reimbursement for facility outpatient, ambulatory surgery, observation and recurring accounts to support the facility coding needs. The Lead OP Coder will be the go-to person prior to taking issues to the Manager. The Lead will orient, coordinate and lead training of new Coders. Gather, research, and help disseminate materials and updates. Will gather feedback and input from Coders and work closely with the manager on evaluating and implementing process improvements or regulatory updates. In addition, the Lead will provide feedback to staff, may audit specific areas needing improvements and monitoring performance of the group.
Demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to Extraordinary Care for Every Generation. Primary patient contact is only social.
Responsibilities
Will perform all the duties of a Level 1 Outpatient Coding Specialist in addition to the following:
Acts at the first line of contact for OP Coders on coding concerns, system issues, guidelines or other issues that arise. Involve the manager as needed.
Tasks search, gather and disseminate updated information.
May be assigned to update guidelines and monitor performance and adherence to work processes, guidelines or standard of work.
Formulates and uses effective working relationships with all members of the HIM department, physicians, contacts from other departments, external customers, Coders, patients and others.
Work closely along the side the manager on tasks and duties.
Adheres to, shares and supports current coding rules, regulations and requirements for outpatient coding, CPT assignment and other tasks completed by outpatient Coders including CCI edits, modifiers and other to ensure quality coding based upon documentation within the patient record.
Identify solutions, edits, improvements or process changes as assists in resolving issues.
Works in conjunction with others as new developments or updates occur.
Solicit feedback from Coders on issues and provide feedback on issues related to inpatient coding tasks.
Develop or update educational, guidelines and/or competencies.
Demonstrate positive customer service, communication skills and maintains confidentiality when communicating with others.
Work with the HIM Leadership and other key contacts in the CBO or departments to improve working relationships and opportunities.
May be required to work with external vendors/customers on issues, audits or projects. Helps to identify solutions to problems and assists in resolving issues.
Monitor OP Coding work queues to assure reasonable completion rate/turnaround timeframes are maintained.
Participates in HIM department meetings and area specific meetings and others are as needed or required.
Assist in achieving departmental, AR and area specific goals.
Participates in identifying lean opportunities to enhance coding efficiency and lower AR.
Maintains professional credentials.
Assist CBO/Finance/Data/CMG/Patient Safety & Quality/Other Departments as requested for follow up on items related to coding, billing and/or reimbursement.
Demonstrates an awareness of legal/confidentiality issues and adheres to all HIPAA Privacy, Security and Department Policies and Procedures.
Participates in development and attainment of department and workgroup goals
Perform other duties as assigned which may include reviewing, analyzing coding denials, denial appeals, denial entry, writing appeal letters to outside agencies, coding quality reviews, mentoring students, or testing for software upgrades.
May develop or maintain guidelines, procedures or policies.
As time allows codes all types of outpatient charts (OP, OBS, ER, ER Pro, Amb Surgery).
Qualifications
EDUCATION/EXPERIENCE REQUIREMENTS:
RHIA, RHIT, or CCS credential required.
Eligible Bachelor, Associate or Degree graduates will be considered with the expectation they pass the national exam.
Three years acute care outpatient coding experience required (diagnosis and procedural coding utilizing ICD10CM and CPT-4 coding books and references including NCCI edits and modifiers).
Must be able to tolerate working under stress, limited time constraints and with frequent interruptions and deadlines and provide feedback to others in a constructive manner.
Knowledge/Skills/Abilities
Basic computer skills.
Knowledge of standard office equipment.
Knowledge of computer use including EMR, email/Outlook, internet, encoder and other software as needed (Vital Ware, Lawson, Word, Excel).
Demonstrates effective communication methods and skills, both verbally and in writing.
Uses appropriate organization/priority setting skills to complete work timely and accurately.
Practices effective problem identification and resolution skills as a method of sound decision making.
Demonstrates interpersonal skills required to work with many other people and personalities.
Requires the ability to use sound judgement, based upon the latest guidelines, federal and state statutes and regulations, as well as hospital and departmental policies.
Ongoing professional growth in many areas.
Ability to sit and look at computer screen for long periods of time.
Ability to be flexible to adjust assignments as priorities change.
The Health Information Management Outpatient Coding Specialist Lead provides timely and accurate clinical and administration data to ensure optimal reimbursement for facility outpatient, ambulatory surgery, observation and recurring accounts to support the facility coding needs. The Lead OP Coder will be the go-to person prior to taking issues to the Manager. The Lead will orient, coordinate and lead training of new Coders. Gather, research, and help disseminate materials and updates. Will gather feedback and input from Coders and work closely with the manager on evaluating and implementing process improvements or regulatory updates. In addition, the Lead will provide feedback to staff, may audit specific areas needing improvements and monitoring performance of the group.
Demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to Extraordinary Care for Every Generation. Primary patient contact is only social.
Responsibilities
Will perform all the duties of a Level 1 Outpatient Coding Specialist in addition to the following:
Acts at the first line of contact for OP Coders on coding concerns, system issues, guidelines or other issues that arise. Involve the manager as needed.
Tasks search, gather and disseminate updated information.
May be assigned to update guidelines and monitor performance and adherence to work processes, guidelines or standard of work.
Formulates and uses effective working relationships with all members of the HIM department, physicians, contacts from other departments, external customers, Coders, patients and others.
Work closely along the side the manager on tasks and duties.
Adheres to, shares and supports current coding rules, regulations and requirements for outpatient coding, CPT assignment and other tasks completed by outpatient Coders including CCI edits, modifiers and other to ensure quality coding based upon documentation within the patient record.
Identify solutions, edits, improvements or process changes as assists in resolving issues.
Works in conjunction with others as new developments or updates occur.
Solicit feedback from Coders on issues and provide feedback on issues related to inpatient coding tasks.
Develop or update educational, guidelines and/or competencies.
Demonstrate positive customer service, communication skills and maintains confidentiality when communicating with others.
Work with the HIM Leadership and other key contacts in the CBO or departments to improve working relationships and opportunities.
May be required to work with external vendors/customers on issues, audits or projects. Helps to identify solutions to problems and assists in resolving issues.
Monitor OP Coding work queues to assure reasonable completion rate/turnaround timeframes are maintained.
Participates in HIM department meetings and area specific meetings and others are as needed or required.
Assist in achieving departmental, AR and area specific goals.
Participates in identifying lean opportunities to enhance coding efficiency and lower AR.
Maintains professional credentials.
Assist CBO/Finance/Data/CMG/Patient Safety & Quality/Other Departments as requested for follow up on items related to coding, billing and/or reimbursement.
Demonstrates an awareness of legal/confidentiality issues and adheres to all HIPAA Privacy, Security and Department Policies and Procedures.
Participates in development and attainment of department and workgroup goals
Perform other duties as assigned which may include reviewing, analyzing coding denials, denial appeals, denial entry, writing appeal letters to outside agencies, coding quality reviews, mentoring students, or testing for software upgrades.
May develop or maintain guidelines, procedures or policies.
As time allows codes all types of outpatient charts (OP, OBS, ER, ER Pro, Amb Surgery).
Qualifications
EDUCATION/EXPERIENCE REQUIREMENTS:
RHIA, RHIT, or CCS credential required.
Eligible Bachelor, Associate or Degree graduates will be considered with the expectation they pass the national exam.
Three years acute care outpatient coding experience required (diagnosis and procedural coding utilizing ICD10CM and CPT-4 coding books and references including NCCI edits and modifiers).
Must be able to tolerate working under stress, limited time constraints and with frequent interruptions and deadlines and provide feedback to others in a constructive manner.
Knowledge/Skills/Abilities
Basic computer skills.
Knowledge of standard office equipment.
Knowledge of computer use including EMR, email/Outlook, internet, encoder and other software as needed (Vital Ware, Lawson, Word, Excel).
Demonstrates effective communication methods and skills, both verbally and in writing.
Uses appropriate organization/priority setting skills to complete work timely and accurately.
Practices effective problem identification and resolution skills as a method of sound decision making.
Demonstrates interpersonal skills required to work with many other people and personalities.
Requires the ability to use sound judgement, based upon the latest guidelines, federal and state statutes and regulations, as well as hospital and departmental policies.
Ongoing professional growth in many areas.
Ability to sit and look at computer screen for long periods of time.
Ability to be flexible to adjust assignments as priorities change.