Lead Certified Professional Coder

Description

Christ Health Center is seeking a dedicated and detail-oriented Quality Coding Lead to support our mission of providing high-quality, compassionate healthcare. This position plays a vital role in ensuring accurate medical coding, optimizing practice performance, and maintaining compliance with national and FQHC coding standards. The Quality Coding Lead assists the Revenue Cycle Manager with daily quality and coding operations, including monitoring payor-related quality scores and incentives to enhance reimbursement and patient care outcomes. This role is responsible for implementing documentation, coding, and billing improvements to drive efficiency and compliance while conducting audits of medical records and claims to ensure accuracy and adherence to regulations. Additionally, the Quality Coding Lead performs coding and billing tasks for commercial and Medicare Advantage payors and collaborates with direct-care staff, medical coders/billers, and the quality team to ensure the correct interpretation and application of medical codes. This position is essential in maintaining the high standards of care at Christ Health Center, ensuring our patients receive the best possible service while optimizing operational effectiveness.

Benefits:

401K & 401K Matching

Medical, Dental, & Vision Insurance

Optional LTD

Employer Paid STD & $25,000 Basic Life Insurance

Paid Time Off

Employee Assistance Program

Schedule: Monday-Friday 7:45 AM - 5 PM

Requirements

Supervisory Responsibilities

• ·None

Major Duties & Responsibilities: Job Skills

• Assists with day-to-day coding and billing tasks, reviewing supporting documentation and charge entry, providing feedback on the Health Center’s performance
• Monitors coding/billing work queues, maintains daily productivity, and addresses areas of greatest need related to coding compliance
• Measures coding success with regular auditing and reporting
• Monitors payer scorecards and incentive reimbursement status’
• Serves as an intermediary between the practice and insurers to address quality incentive needs
• Evaluates charge capture and coding workflows for maximum efficiencies, making recommendations as necessary
• Maintains a knowledge of coding changes and requirements
• Responsible for answering coding related questions from clinical staff
• Reviews and reconciles missed charge reports
• Creates and distributes coding tip sheets to appropriate parties as needed
• Assists with education in-services for physicians, other providers, and clinical staff relating to documentation, coding, and charging guidelines
• Performs other duties as assigned

Required Skills/abilities

• Excellent verbal, organizational and written communications skills.
• Requires analytical skills, attention to detail, effective organization skills, ability to work in a fast-paced environment and ability to self-direct with minimal supervision.
• Requires the ability to work in a multi-cultural setting (Bi-Lingual in Spanish is preferred)
• Proficient in Microsoft Office (Word, Excel, Outlook)

Qualification, Education, Experience

• Associates degree or higher
• Minimum of 2 years Coding experience preferably in a physician office
• Certification as Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Coding Specialist (CCS), or Certified Coding Specialist Physician-Based (CCS-P) or a Certified Coding Associate (CCA) required
• Experience with Medicaid, Medicare and commercial claims filling
• Payor quality experience preferred
• FQHC Experience preferred
• Athena experience preferred

Attendance Standards

Punctual and dependent for assigned/confirmed shifts.

Language Skills

Ability to read and comprehend simple instructions, short correspondence, and memos; ability to write simple correspondence and reports; Ability to effectively present information in one-on-one and small group situations to patients, visitors, and other employees of the organization.

Mathematical Skills

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals; ability to compute rate, ratio and percent.

Reasoning Ability

Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems. The ability to combine pieces of information to form general rules or conclusions (includes finding a relationship among seemingly unrelated events).

Physical/Mental Demands

• Work requires the ability to move and transport objects weighing up to 20 pounds.
• Work requires the ability to remain in a stationary position +/- 90% of the time.
• Work requires the ability to position self to move and good manual dexterity.
• Work requires the ability to communicate, converse with (in-person and over the phone), and exchange information effectively with others.
• Work requires visualizing, identifying, inspecting, and operating a computer and other office machinery, including a computer monitor, keyboard, mouse, and printer.
• Work requires the ability to inspect documents for accuracy.
• OSHA personal exposure risk category I & II.
• Airborne personal exposure risk category I (Possible exposure of the healthcare worker to patients capable of transmitting M. tuberculosis). Universal precautions will be adhered to at all times.

Cultural Expectations

• Understands Christ Health Center Mission Statement and Values
• Consistently displays Christ Health Center’s Mission on a daily basis
• Treats patients, visitors and co-workers with love and respect