Luminis Lead Medical Coder
1 day ago
Must-have
- HS Degree or equivalent
- Certified as a CPC, CIC or CCS.
- At least 5 years of coding experience in a hospital setting (inpatient + outpatient knowledge)
- At least 2 years of previous experience in a working supervisor or lead role.
- Maryland experience, proficient knowledge of MS-DRG and APR-DRG coding.
- Previous experience working in EPIC.
Plusses
- Registered Health Information Technician (RHIT), Registered Health information Administrator (RHIA)
Day to day:
Insight Global is seeking Lead Medical Coder to support a large healthcare system based out of Annapolis, MD. The Medical Lead Coder under the supervision of the Manager of Coding and Data Quality In accordance with Luminis Health coding guidelines, ICD-10-CM Official Coding Guidelines for Coding and reporting and other authoritative resources assists with oversight of daily inpatient and outpatient coding operations. This will include work volume and distribution, workflow evaluations and testing. This position will also include reviewing and reconciling reports, providing coding training within the Coding Department, and performing research on coding issues. This position will entail 30% oversight, 70% high level coding. Must have knowledge of combined accounts. This Lead will be working in the work queues, focused in errors, and troubleshooting the wrong code. They will have oversight of inpatient and outpatient coding.
Essential Job Duties:
- Review Inpatient medical records, including patient histories, examination findings, diagnoses, and treatment plans, to extract pertinent information for code assignment. Assign the principal and significant secondary ICD-10-CM diagnosis codes, in addition to present on admission indicators, and ICD-10-PCS procedure codes, using official coding guidelines and knowledge of anatomy and physiology, pharmacology and pathophysiology/disease processes. Ensure compliance with coding guidelines, conventions, and regulatory requirements, including adherence to HIPAA (Health Insurance Portability and Accountability Act) privacy regulations.
- Utilize coding references, software tools, and electronic health records (EHR) to facilitate accurate and efficient code assignment.
- Maintain a high level of accuracy in code assignment to prevent claim denials, billing errors, and potential legal issues.
- Stay updated with coding changes, industry trends, and regulatory updates to ensure coding practices align with the latest guidelines and requirements.
- Collaborate with healthcare providers, billing staff, and other stakeholders to clarify documentation, to resolve coding-related queries, and to ensure accurate and timely claim submission and reimbursement.
- Participate in ongoing education, training, and certification programs to enhance coding proficiency and maintain credentials.
- Uphold professional ethics, integrity, and confidentiality in handling patient information.
- Communicate and collaborate with healthcare providers to clarify documentation, obtain necessary information for accurate code assignment, and resolve coding-related queries.
- Ensure documentation supports the codes assigned and accurately reflects the services provided to maintain compliance with coding guidelines.
- Stay updated on changes to coding regulations, payer requirements, and industry trends to ensure coding practices align with the latest standards.
- Analyze complex medical scenarios and make informed decisions regarding code selection based on the documentation provided.
- Conduct regular audits and quality assurance reviews to monitor coding accuracy, identify areas for improvement, and implement corrective measures as needed.
- Generate reports and provide coding-related data analysis to support healthcare management and decision-making.
- Stay informed about coding compliance standards and assist in the development and implementation of coding policies and procedures.
- Collaborate with the revenue cycle team to ensure seamless billing and reimbursement processes.
- Serve as a resource for coding-related questions and provide guidance to colleagues and team members as needed.
- Actively participate in coding team meetings, departmental meetings, and professional development activities to share knowledge, exchange best practices, and contribute to the growth of the coding team.
- Adhere to professional coding ethics and standards, including maintaining patient confidentiality and privacy.
- Provide support during external coding audits, including cooperating with auditors, providing documentation, and addressing any findings or recommendations.
- Assist with the implementation of coding-related software, updates, and system enhancements to optimize coding processes.
- Maintain a positive and collaborative working relationship with healthcare providers, billing staff, and other stakeholders to foster effective teamwork and communication.
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