Quality Coding Lead

Christ Health Center is seeking a Quality Coding Lead to support our Revenue Cycle team in ensuring accurate, compliant, and high-quality coding and documentation practices. In accordance with national and FQHC coding guidelines, the Quality Coding Lead assists the Revenue Cycle Manager with oversight of daily quality and coding operations. This includes monitoring payor related quality scores and incentives, implementing documentation, coding, and billing changes to improve practice performance, auditing documentation and claims, and completing coding/billing tasks for commercial and Medicare Advantage payors. This position will support direct-care staff, medical coders/billers, and the quality team to ensure compliant interpretation and use of medical codes.

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