Physician Billing Coding Lead

About the role

The Pro-Fee Coding Lead will be responsible for reviewing medical documentation and assigning CPT and ICD-10 for various department of the organization. The Pro-Fee Coding Lead will work collaboratively with the Coding Manager, Physician Billing to maintain day-to-day coding operations and various projects and duties assigned. Essential Job Functions: - Performs coding functions as needed for Lurie/Outreach Locations. - Monitors coder's productivity by collaborating with Coding Manager to meet designated productivity and quality benchmarks. - Resolves questions, issues and patient disputes with third party payors, billing coordinators, compliance auditors, external billing company and denial management team that pertain to coding. - Prepares department coding feedback materials based on trends and issues identified via Coding WQ's and coding denial trends. - Works with Coders and Audit Manager to resolve denials, identify trends and implement process improvements to increase clean claim rate and improve denial recovery rate. - Collaborates with Coding Manager to improve Charge Review Work queues workflow thru various WQ improvement initiatives. - Collaborates with Coding Manager regarding content for Coders Monthly Meeting including preparing education materials, room reservation and other tasks requirements. - Collaborates with Coding manager to perform and complete revenue cycle coding projects - Develops and maintains division specific coding protocols. - Assists Coding Manager with employee time management on a weekly basis including staffing coverage. - Assigns appropriate ICD-10-CM diagnosis code(s), CPT procedure codes and modifiers using coding conventions, guidelines and payor specific requirements. - Abstract and compile data from medical records for appropriate optimal reimbursement. - Works actively with physicians to initiate corrections and resolve discrepancies in coding and documentation. - Works collaboratively with physicians to assure accurate and timely submission of claims. - Provides feedback at division meeting around documentation and coding. - Submits help desk tickets and CIS for coding and collaborates with IM for resolution. - Collaborates with Coding Manager on month end close numbers for coding. - Provides regular communication and education to providers and other clinical teams as indicated. - Acts in the capacity of liaison to providers, managers and other coding team members. - Ensures that all charges are submitted accurately and in a timely manner. - Works collaboratively with Compliance Auditors to identify trends, billing opportunities and physician education needs. - Performs job functions adhering to service principles with customer service focus of innovation, service excellence and teamwork to provide the highest quality care and service to our patients, families, co-workers and others. - Performs other related duties as assigned. Knowledge, Skills, and Abilities: - Minimum Of Associate Degree is Required. High School Diploma required. - Coding credentials required such as RHIT, RHIA, CPC, CCS-P and other surgical coding credentials. - Requires 3-5 years coding work experience. - Working and performance knowledge for divisions within the assigned coverage area preferred - Management and Project Management preferred - Demonstrates thorough knowledge of CPT and ICD-10-CM coding. - Maintains a thorough understanding for medical record practices, standards, regulations, Joint Commision on Accreditation of Health Organizations (JCAHO) and Illinois Medicaid coding and reporting requirements. - Demonstrates understanding of medical terminology, anatomy and physiology and coding classification systems and is able to apply this knowledge in determining appropriate physician coding. - Demonstrates the ability to communicate effectively with providers, co-workers and managers. - Demonstrates the ability to work independently and balance multiple priorities. - Demonstrates the ability to use multiple types of computer software (i.e., Word, Excel, EPIC, 3M, SharePoint, etc.). Education Associate's Degree (Required) Pay Range $70,720.00-$115,627.20 Salary At Lurie Children's, we are committed to competitive and fair compensation aligned with market rates and internal equity, reflecting individual contributions, experience, and expertise. The pay range for this job indicates minimum and maximum targets for the position. Ranges are regularly reviewed to stay ali

Benefits

Additional Information

Ann & Robert H. Lurie Children's Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children's Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report. Location 680 Lake Shore Drive Job Description

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