— Coding Lead

Renown Health; Reno (NV); Hybrid; USD 45,130 - 63,190; Full time

Benefits offered by this job

Paid Time Off

401(k) Company Match

Flexible Work Environment

Job summary

Renown Health is seeking a Coding Lead in Reno, NV. The role involves ensuring timely coding for reimbursement, mentoring coding staff, and maintaining compliance with billing guidelines. Key responsibilities include reviewing coding for accuracy, monitoring workflows, and providing expert coding knowledge to clinical staff. This full-time position allows remote work for candidates in approved states. Compensation ranges from $32.76 to $45.87 per hour, alongside benefits like paid time off and a 401(k) matching plan.

Qualifications

• Expert knowledge of ICD-10-CM diagnostic coding.
• Ability to lead and mentor coding staff.
• Experience with billing compliance and regulatory requirements.

Responsibilities

• Respond to escalations from coding staff and external departments.
• Ensure timely and accurate coding, billing, and compliance.
• Monitor quality of coding and provide feedback.

Skills

ICD-10-CM coding expertise

Compliance knowledge

Problem-solving skills

Mentoring and leadership

Education

Coding certification

Tools

Electronic Medical Record (EMR) systems

Job description

# Coding LeadRequisition ID: 186388Department: 100738 Facility CodingShift: VariesCategory: Clerical & Administrative SupportSalary: 32.76 - 45.87### Paid Time Off### 401(k) Company Match### Flexible Work EnvironmentRenown Health is northern Nevada's healthcare leader and Reno's only locally owned, not-for-profit health system. We are an entire network of hospitals, primary care offices, urgent care centers, lab services, medical specialties, and x-ray and imaging services - with more than 7,000 nurses, doctors and care providers dedicated to the health and well-being of our community.**For Providers:** Renown Health and the University of Nevada, Reno School of Medicine (UNR Med) are affiliate partners in Nevada's first integrated academic health system. The affiliation aims to improve the health of the community, region, and state through research, medical education, and expanded clinical care. Renown physicians participate as joint faculty at UNR Med for teaching, lectures, supervising clinical rotations, and other academic activities for the education of medical and physician assistant students, residents and fellows.Schedule: Full Time - Eligible for BenefitsThis position is open to remote candidates who reside in one of the following states only: **Texas, Arizona, Utah, Florida, Idaho, Oregon, Washington, or California.**Due to business operations, tax registration, and employment compliance requirements, we are only able to hire individuals who currently live and work in these states. Applicants must maintain residency in one of the approved states as a condition of employment.Position PurposeThe Coding Lead position is accountable for responding to escalations from internal coding staff as well as external departments and costumers to ensure compliance and revenue related to reimbursement is coded and billed within appropriate timelines. This position is responsible for maintaining departmental standard work and keeping abreast of continual changes in coding and billing guidelines and compliance related to reimbursement within federal and State regulations. This incumbent is to have expert knowledge of accurately assigning ICD-10-CM diagnostic and procedure codes for all aspects of professional services coding or facility coding.Nature and ScopeIncumbent will also perform highly complex and specialized coding, including review analysis. The major challenge of this position is ensuring the accountable coding for each patient type is completed within designated timelines. This position is challenged to keep workflows running smoothly for the department, including charge related items in work queues to ensure correct and timely billing. This position is accountable to bring issues and the need for revised/additional policies and procedures to management’s attention.Incumbent will serve as a resource to all coders, revenue cycle staff, providers, and clinical staff on coding questions, documentation requirements, and coding guidelines. This candidate must be able to identify and resolve problems, set goals and priorities, and represent the department in a professional manner as well as in the absence of Leadership, as assigned.Specific job responsibilities by section include:HIM Coding Lead **(Facility)**:This list is to include but is not limited to coding and resolving escalations regarding; Acute Inpatient/Outpatient, Level II Trauma, Inpatient Rehab Facility, Home Health, Hospice and Hospital Outpatient Departments. Feedback and correction of ICD-10-CM/PCS and CPT code assignments, corrections and advice must be consistent with CMS Official Guidelines, regulatory agencies and hospital specific bylaws and guidelines.Other responsibilities include:• Work in collaboration with other Coding Lead staff members and colleagues to facilitate timely completion of critical medical record reviews for coding accuracy as directed or otherwise needed by CDI department, Quality and Compliance department, Business office, Data Integrity department, and other departmental business partners as needed.• Identify Patient Safety Indicators and Hospital Acquired Conditions as being correctly coded and assist Clinical Documentation teams in making meaningful documentation clarifications.• Reviews cases coded by staff and contract coders for accuracy and compliance with Coding Clinic and facility guidelines.• Act as subject matter expert and advocate for coding while maintaining objective.• Monitor quality of coding, document findings, present feedback to individual coders and report findings to Coding Leadership.• Serve as a leader through modeling, mentoring, and training assigned staff.• Manages assigned charge review and coding-related claim work queues to ensure timely and accurate charge capture. Accurately deciphers charge error reasons and plan follow-up steps.• Ensures all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI) or payer-specific guidelines.• Contacts providers and/or support staff when clarification is needed to appropriately bill for services. Ensures all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI) or payer-specific guidelines.• Corrects claim edit errors in the work queues, assures charges provide optimal appropriate reimbursement with appropriate documentation.• Corrects claim edit errors in the work queues, assures charges provide optimal appropriate reimbursement with appropriate documentation.• Provides feedback and guidance to coders and clinicians on recurring errors.• Suggests rules to proactively work these edits prior to claim edit.• Performs other duties as assigned.• Review and reconcile reports associated with charge review, work queues, claim edit work queues, monthly write-offs and denial management.• Stays current on coding and compliance regulatory requirements through professional membership literature, continuing education classes, support, and networking groups.• Maintains coding certification and attends in-service training as required.• Identify and troubleshoot EMR coding queues and encoder workflows consistent with requirements of Coding Leadership.• Utilize the appropriate physician clarification process to obtain additional information that provides a codable sign, symptom, or diagnosis and/or physician order.The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.Incumbent must have skill set to:• Addresses appeals and complex medical record review needed for insurance denials to facilitate expedient resolution and reimbursement.• Participates in mandated Medical Record Review processes.• Interprets and applies American Hospital Association (AHA) Official Coding Guidelines to articulate and support appropriate principal, secondary diagnoses and procedures.• Ensures that all factors necessary for assigning accurate DRG, ICD-10 CM, ICD-10 PCS and/or CPT, HCPCS, E & M and modifiers are present, and that related diagnoses are ranked properly when applicable.• Assign accurate present on admission indicators when applicable.• Provides information and responds to inquiries regarding medical documentation and DRG’s, PSI’s and HAC’s to CDI staff including Utilization and Quality Assurance Departments when needed.• Knowledge of discharge disposition and reimbursement outcomes.• Adherence to Health Information Management (HIM) Coding policies.• Adherence to The Joint Commission (TJC) and other third-party documentation guidelines in an effort to continually improve coding quality and accuracy.• Responsibility for maintaining coding certification and referencing current ICD-10 coding guidelines and regulatory changes.• Participates