Outpatient Coder Lead

Where You’ll Work

With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.

Job Summary and Responsibilities

As our Outpatient Coder Lead, you will code and abstract outpatient records for data retrieval, analysis, reimbursement, and research, ensuring complete charge capture, and providing expert guidance to coding and hospital staff.

Every day you will direct Outpatient Coding Service Center operations including personnel management, training, education, productivity, work assignments, and quality reviews. You will assist with coding education, audits, denials, claim edits, and CHA data submissions, promoting standardization and managing DNB and coding compliance to achieve financial goals and improve the accuracy and integrity of patient data.

To be successful in this role, you will possess expert-level outpatient coding proficiency, strong leadership and management skills, a deep understanding of coding regulations and reimbursement methodologies, and the ability to drive accuracy, quality, and standardization across coding operations, while effectively collaborating with Revenue Management and other departments.

• Demonstrates proficiency in coding and abstracting outpatient accounts in the electronic medical record system, completes charge capture/review as applicable, and creates APC group assignments while adhering to coding guidelines, regulations, and compliance plan.
• Conducts and assists quality audit reviews in a timely manner and effectively communicates feedback to stakeholders.
• Answers coding questions in accordance with the Coding Compliance plan, Official Coding Guidelines, and regulatory billing guidelines.
• Assists Manager with managing DNB, coder productivity, and quality to ensure alignment and support of achieving corporate/service center and hospital financial goals.
• Facilitates and/or assists with coding training and education to promote accurate coding and reimbursement practices per coding guidelines, regulatory requirements, and the organization's coding compliance plan.
• Works with the outpatient coding team to improve the coding accuracy, integrity, and quality of patient data, to ensure minimal variation in coding practices.

Job Requirements

Required

• High School Diploma/G.E.D.
• Minimum of four (4) years of outpatient coding experience in an acute care setting
• Current AHIMA credentials (i.e. RHIA, RHIT, CCS, CCS-P) or AAPC credential (COC, CIC, CPC-H, CPC)
• Must demonstrate competency of outpatient and observation coding guidelines as well as other outpatient coding guidelines
• Demonstrate advanced knowledge of Coding Clinic Guidelines, and advanced technical knowledge with coding competency in ICD-10 CM, CPT, HCPCS and Nosology
• Advance knowledge of disease management, anatomy and physiology, medical terminology, pharmacology and coding systems (i.e. 3M)

Preferred

• Associate's Degree
• Charge capture experience