Provider Coding Specialist Lead

PeaceHealth; Bellingham (WA); On-site; USD 48,000 - 72,000; Full time

Job summary

PeaceHealth is seeking a Provider Coding Specialist Lead for a Full Time, 1.00 FTE, Day position. The role coordinates day-to-day coding operations, acts as subject matter expert, and supports leaders in achieving departmental goals within a healthcare setting.

The position requires extensive knowledge of CPT/ICD-10 coding, documentation quality, and collaboration with billing staff to ensure accurate reimbursements. Leadership experience is preferred.

Qualifications

• Accredited program or combination of education and experience providing coding knowledge.
• Minimum 5 years directly related work experience in provider coding, billing, charge capture, or audits.
• Knowledge of anatomy, physiology, medical terminology, diseases, procedures and therapies.
• Certifications within 1 year: CPC, CCS-P, RHIT, RHIA, COAPCOD or CCS as applicable.

Responsibilities

• Assigns work, manages priorities, mentors staff, and oversees training.
• Processes billing system claim edits and reviews CPT/ICD-10 coding and documentation for accuracy.
• Reviews denied claims and recommends corrections.
• Assists providers and billing staff with coding questions.
• Researches coding/compliance issues using regulatory and medical resources.
• Collaborates with coding reviewers and facilitates coding huddles.
• Maintains coding workflows and uses computer-assisted coding tools.
• Performs provider queries using EHR workflows and participates in regular meetings.
• Performs other duties as assigned.

Skills

Coding proficiency

EMR systems

MS Office

Communication skills

Problem solving

Billing knowledge

Education

Accredited coding education

Tools

EMR encoders

Coding resources/tools

Job description

Description

PeaceHealth is seeking a Provider Coding Specialist Lead for a Full Time, 1.00 FTE, Day position. The salary range for this job opening at PeaceHealth is $34.74 – $52.12. The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.

Job Summary

Responsible for coordinating the day-to-day functions for assigned area. Assists with ensuring that departmental goals are achieved, timelines met and service excellence provided in all aspects of work. Subject matter expert.

Essential Functions

• Assigns work; plans and manages priorities, provides technical assistance, oversees staff schedules, monitors quality of work, monitors team projects, mentors staff, provides constructive feedback, oversees staff training, ensures quality improvement, provides leadership feedback on staff performance, and assists with goal setting for the team.

• Processes billing system claim edits and reviews CPT/ICD-10 coding and medical record documentation submitted by providers for accuracy prior to billing.

• Reviews claims denied due to coding issues and makes corrections/recommendations for corrections.

• Assists providers and PFS billing/reimbursement staff with coding questions.

• Researches coding/compliance issues utilizing regulatory and medical informational resources.

• Collaborates with coding reviewers by providing feedback regarding trends identified during the daily coding process and attend provider reviews as assigned

• Facilitates coding huddles.

• Prioritizes coding functions as directed by coding leadership and organizes job functions and work assignments to efficiently complete tasks within the established time frames.

• Utilizes computer assisted coding tools, in accordance with, established coding workflows.

• Conducts provider queries of identified documentation issues utilizing EHR established workflows

• Participates in meetings including, departmental, provider, clinical operations, billing using virtual technology or face to face as needed

• Performs other duties as assigned.

Qualifications

Education

• Accredited Program Required: Coding or combination of education and experience that provides the caregiver with the requisite knowledge, skills and abilities to perform the job and

Experience

• Minimum of 5 years Required: Experience of directly related work experience in provider coding, billing, charge capture or provider review/auditing and

• Required: Knowledge of anatomy, physiology, medical terminology, diseases, procedures and therapies and

• Preferred: Previous leadership or supervisory experience

Credentials

• Required: within 1 Year Certified Professional Coder or

• Required: within 1 Year Certified Coding Specialist Physician or

• Required: within 1 Year Registered Health Information Technician or

• Required: within 1 Year Registered Health Information Administrator or

• Required: within 1 Year Certified Outpatient Coder or

• Required: within 1 Year Certified Coding Specialist

Skills

• Proficiency in coding Professional Inpatient and/or Ambulatory Care, Emergency Department and Outpatient medical records with ICD-10 CM and CPT4 classification systems with expertise in one or more specialty area. (Required)

• Proficient in the use of MS Office applications including Excel and Word. (Required)

• Proficient in EMR, encoders, coding resource toolsMust be able to manage conflict effectively and professionally. (Required)

• Adept and proficient in windows-based computer environment with respect to coding software systems. (Required)

• Good verbal and written communication skills (Required)

• Critical thinking and problem-solving skills. (Required)

• Familiarity with medical billing software and electronic medical record. (Required)

Department / Location Specific Notes

Working Conditions

Lifting

• Consistently operates computer and other office equipment.

• Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.

• Sedentary work.

Environmental Conditions

• Predominantly operates in an office environment.

Mental/Visual

• Ability to communicate and exchange accurate information.

• The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.

PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program.

See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility.

For full consideration of your skills and abilities, please attach a current resume with your application. EEO Aff... Employer/Vets/Disabled in accordance with applicable local, state or federal laws.