Lead Coder

Job Summary:

Assists in monitoring staff coding quality. Ensures compliance with government and coding regulations and standards. Performs internal and corporate medical record coding audits as needed and acts as a coding expert resource for the HIM Director, HIM department and hospital. Regularly performs discharge coding in accordance with ICD-10 and CPT-4 coding guidelines and corporate coding policies. Assists in training and evaluating assigned coding staff. Acts as a coding operation support resource to Coding/CDI Coordinator as needed. Assists in review and/or appeals of payer denials/DRG downgrades. Acts as a coding resource to Medical Staff, Patient Financial Services and other hospital departments. Collaborates with and provides guidance to CDI staff in facilitating ongoing documentation improvement process by educating physicians, nurses, and other facility staff as needed on documentation requirements to ensure appropriate and optimal DRG. Educates physicians and other hospital staff on reimbursement issues, as appropriate.

Regulatory Requirements:

• RHIT or CCS Credential
• 3-5 years acute care hospital coding experience
• Associates degree preferred
• Knowledge of diagnoses/procedures in accordance with ICD-9-CM and CPT-4 coding principles
• Strong knowledge of medical terminology and anatomy and physiology.

Ability to work with physicians and hospital staff in a collaborative manner

Language Skills:

• Ability to read and communicate effectively in English
• Well developed listening, verbal and communication skills.

Skills:

• Basic computer knowledge
• Ability to multi-task and take initiative to suggest process improvements.

Physical Demands:

• For physical demands of position, including vision, hearing, repetitive motion and environment, see following description.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising client care.