Lead, Coding

4 weeks ago

Joliet, United States QualDerm Partners, LLC Full time
Job DescriptionJob DescriptionDescription:

With 150+ locations in 17 states, QualDerm Partners is the largest multi-state female-founded and owned dermatology network in the U.S. At QualDerm Partners, we are united in our purpose: to educate, protect, and care for your skin. We are committed to bringing you the very best in comprehensive skin care so that you can achieve a confident, healthier, and more beautiful you Our mission is to educate communities and healthcare professionals about the importance of skin health; including skin cancer prevention, risk factors and how to achieve healthy skin through annual skin exams and dermatologic care. We strive to provide the latest proven, proactive and comprehensive dermatologic care to populations in the expanding geographies we serve by making high-quality skin care timelier and more accessible all while creating a rewarding work environment for our providers and employees.


Position Summary

This position works with a professional team of physicians and other staff who are trained in the medical and surgical specialty of dermatology with the purpose to be patient focused with the objective of delivering superior patient care and ensuring a positive patient experience and outcome.


The Coding and Billing Team Lead is responsible for the billing/coding needs of all QualDerm Partners practices and providers, as assigned. This position reports to the Director, Revenue Integrity and/or Vice President Revenue Cycle.


Essential Responsibilities

  • Review and audits medical records for correct CPT, ICD-10, and HCPCS codes for multiple providers in each practice throughout the Company and make corrections as necessary.
  • Manage claims returned which have failed scrub rules.
  • Monitor Payer Par daily.
  • Monitor missing charges daily and communicate with providers, lead and managers as needed.
  • Assists with pre and post audits while maintaining compliance with payer reimbursement policies and government regulations as well as Medicare/CMS guidelines.
  • Analyze code, interpret and compile medical information/records to document patient condition and treatment.
  • Code, prepare and submit clean claims to insurance companies via electronic and paper submissions.
  • Keep Billing-Coding Team Lead informed as necessary related to coding/billing/documentation
  • Maintains required CEUs.
  • Work with management and staff to ensure the front desk is an integral part of billing/collection process.
  • Provide training for new employees.
  • Assist with inbound calls from patients, providers and other staff members
  • Communicates with team members in a courteous, professional, cooperative, and mature manner.
  • Treats staff, physicians, visitors and patients with dignity and respect.
  • Adheres to Code of Conduct and Mission & Value Statement.


Qualifications

  • Excellent oral and written communication skills, thinks critically and strategically.
  • Excellent relationship-building skills and works well with others using tact and diplomacy.
  • Must be highly professional in appearance, tone and delivery and an effective communicator.
  • Dedicated to follow-thru and results.
  • Flexibility as it relates to schedule, responsibilities, and priorities.
  • Knowledge of dermatology practice preferable.
  • Must be an exceptional listener, with the proven ability to problem-solve issues discussed.
  • Interpersonal skills and strong organizational skills are important.


Education and/or Experience Requirements

  • High school graduate or GED.
  • Certified Professional Coder (CPC) or Certified Dermatology Coder (CDC). Additional Certified Professional Biller (CPB) a plus.
  • 3-5 years of experience in medical coding/reimbursement, dermatology preferred.
  • Good knowledge of ICD10-CM, and CPT coding principles and guidelines.
  • Good knowledge of reimbursement systems, as well as federal, state and payer-specific regulation.
  • Must possess and maintain knowledge of coding/billing regulations and payment systems for federal and government related programs and the ability to apply this knowledge to other payers.
  • Working knowledge of Microsoft and payer software.
  • Ability to work during times of unusually high volume and/or unusual need as workload demands.


Benefits of Joining QualDerm Partners

  • Competitive Pay
  • Medical, dental, and vision
  • 401(k) - The company match is 100% of the first 3%; and 50% of the next 2%; immediately vested
  • Paid Time Off - accrual starts upon hire, plus 6 Paid Holidays and 2 Floating Holidays
  • Company paid life insurance and additional coverage available
  • Short-term and long-term disability, accident and critical illness, and identity theft protection plans
  • Employee Assistance Program (EAP)
  • Employee Discounts
  • Employee Referral Bonus Program


QualDerm Partners is proud to be an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Applicants must be currently authorized to work in the United States in a full-time basis.

Requirements:


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