[Hiring] Lead Coding Quality @CorroHealth

Role Description

The Lead Coding Quality Specialist is responsible for directing the day-to-day work of a small team of coding quality specialists (auditors) who provide internal hospital and physician (provider) auditing. The Lead must have the ability to accurately audit and code (ICD-10-CM, ICD-10-PCS, CPT, HCPCS, Level I & II modifiers) all of the following service types:

• Facility inpatient
• Emergency room
• Outpatient surgery
• Observation
• Ancillary
• Recurring therapy
• Clinic
• Professional
• Billing/coding edit resolution

The Lead will work with multiple facility-specific and state billing and coding guidelines, as well as various Medicare Administrative Contractors nationwide, and will collaborate with the Coding Department on coding audits and training.

Duties:

• Lead a team of coding quality specialists, including assigning tasks, ensuring deadlines are met, and mentoring and training staff on quality and compliance.
• Ensure compliance with departmental standards and coding practices.
• Ensure team members are working efficiently and meeting performance expectations.
• Conduct regular code reviews to assess quality, compliance, and risk.
• Identify coding issues and recommend corrective actions.
• Communicate audit findings to staff and management.
• Maintain detailed records of audits and outcomes.
• Align conduct with AHIMA's Standards of Ethical Coding and the Company's Code of Ethics and Business Conduct and support the Company's Ethics and Compliance Program.
• Comply with all internal policies and procedures.
• Actively participate in Company provided training and education.
• Ensure individual compliance with all privacy and security rules and regulations and commit to the protection of all Company confidential information, including but not limited to, Personal Health Information.
• Required to audit the work of their aligned team.
• Required to audit and code as part of individual responsibility.

Qualifications

• Must have 3+ years of production coding experience, including hospital and/or physician practice, inpatient coding experience, and prior auditing experience.
• Must have one of the following Coding Certifications: Certified Inpatient Coder (CIC); Certified Coding Specialist (CCS).
• Must be certified through either the AAPC (CPC or COC) or AHIMA (CCS or CCS-P).
• Must have an understanding of healthcare billing practices and compliant claims preparation for both governmental and commercial payers.
• Regular, predictable, and punctual attendance is required.
• Must have working knowledge and experience with systems such as EMR, Billing, etc.
• Must have a phone, reliable internet connection, and current coding materials such as CPT and ICD-10-CM coding references.
• Will be required to maintain an ongoing productivity level and accuracy rate of 95% or higher.
• Will be required to maintain a quality score of 95% or higher.
• Must be proficient in Microsoft programs like Excel and Outlook.
• Ability to communicate effectively and professionally both verbally and in writing.
• Ability to coordinate, analyze, observe, make decisions, and meet deadlines.
• Demonstrated ability to lead and direct the work of others.
• May be required to perform other duties as assigned by Leadership Team Member.

Physical Demands

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Members must be able to lift and move material weighing up to 20 lbs. Team Members may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.