Team Lead, HCC Coding

 About Us:

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. 

We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.  

JOB SUMMARY:

ESSENTIAL DUTIES AND RESPONSIBILITIES: 
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

• Team Member must be able to work from home and be independent in their coding skills.

• Review pending accounts for opportunity to complete.

• Working client reports – edits, failed claims, etc.

• Assists in research and resolution of QA disputes.

• Testing system changes related to specific client hospitals.

• Work with CCM/QA team on Managerial Review charts.

• Assist with coding and/or auditing of charts as needed.

• Assist with education and/or training of coders as needed.

• Align conduct with AHIMA's Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct and support the Company’s Ethics and Compliance Program.

• Accurately apply diagnosis and procedure codes utilizing ICD-10-CM, ICD-10-PCS, CPT®, and HCPCS.

• Interpret coding guidelines for accurate code assignment.

• Identify the importance of documentation on code assignment and the subsequent reimbursement impact.

• Comply with all internal policies and procedures.

• All Coders and Leads must maintain at least one credential through either AAPC or AHIMA.

• Actively participate in Company provided training and education.

• Ensure individual compliance with all privacy and security rules and regulations and commit to the protection of all Company confidential information, including but not limited to, Personal Health Information.

MINIMUM QUALIFICATIONS & REQUIREMENTS:

• All coders MUST be certified through either the AAPC (CPC or COC) or AHIMA (CCS or CCS-P).

• Must have a phone, reliable internet connection and current coding materials such as CPT and ICD-10-CM coding references. 

• Must have a minimum of 2 years of experience.

• Regular, predictable, and punctual attendance is required.

• Ability to communicate effectively and professionally both verbally and written.

• Ability to prioritize workload, to meet deadlines and to maintain a high level of quality and accuracy

• Initiative, resourcefulness, and attention to detail.

• Must be intermediate or advanced level in Microsoft Office programs such as Excel and Outlook. Examples include:

  • Excel: you should be able to open and add to a spreadsheet, perform formulas like adding, multiplying, and VLOOKUP, as well as create pivot tables and charts and graphs.

  • Outlook: you should be able to manage emails, tasks, contacts, and schedule and attend meetings.

• Ability to navigate in a variety of EMR environments and review hand-written charts.

• Ability to coordinate, analyze, observe, make decisions, and meet deadlines. 

• May be required to perform other duties as assigned by Leadership Team Member.

Preferred:

• Associate degree or higher in a healthcare-related filed.

• Four plus years of experience.

PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.