Senior Coder - Professional Coding

Yale New Haven Health; New Haven (CT); On-site; USD 90,000 - 115,000; Full time

Job summary

Yale New Haven Health is seeking a Professional Senior Coder to lead professional coding activities, provide subject matter expertise, and perform QA reviews. This role focuses on Pre-AR management, education, and collaboration with partner departments to improve coding accuracy and revenue cycle performance.

Ideal candidates have 5+ years in professional coding, Epic experience, and a track record of mentoring teammates while maintaining high coding quality across multiple specialties.

Qualifications

• Bachelor's degree preferred in a health-related field; anatomy and physiology coursework preferred.
• Five+ years of progressive coding experience in Professional Coding.
• Must be proficient in most professional specialties and have Epic experience.
• Audit educator and/or coding lead experience preferred.

Responsibilities

• Manage day-to-day activities related to Professional Coding AR to ensure accuracy and timeliness of charge review.
• Serve as a subject matter expert in professional coding workflows to staff and partner departments.
• Conduct regular QA reviews to identify coding errors and trends and mentor staff.
• Code across multiple professional specialties and maintain high coding quality.
• Lead educational sessions and mentor team members to improve AR outcomes.
• Prioritize workload to impact department goals and support staff when needed.
• Possibly serve in lead capacity in supervisor's absence and cover vendor coordinator.
• Perform other duties or special projects as assigned by manager.
• Demonstrate professionalism and commitment to departmental goals and values.

Skills

Mentoring team members

Professional coding

Excel analytics

QA and education

Education

Bachelor's degree preferred in a health-related field

Tools

Epic

Dashboards / reporting tools

Job description

Overview

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

The Professional Senior Coder is a vital multifaceted role within the Coding Department. This position provides support as Professional coding subject matter expert, educator, QA reviewer, and also focuses daily efforts on Pre-A/R management and oversight. Additionally, this person works with partner departments to problem solve issues and streamline processes. The Professional Senior Coder is also required to mentor other team members and also prepare them for the role of Senior Coder. This individual possesses a strong level of Professional clinical coding expertise, expansive knowledge of professional coding guidelines, and has the ability to handle multiple priorities. This position requires strong ICD-10, CPT and modifier coding skills, in addition to being able to perform QA reviews, educate and mentor team members, help to manage the Pre-AR and provide oversight and communication within a specialty focused team-based environment.

EEO/AA/Disability/Veteran

Responsibilities

• Manages in collaboration with the Coding Leadership team to help manage and actively assist with the day-to-day activities related to Professional Coding AR to ensure accuracy, completeness, and timeliness for charge review.
• Serves as a subject matter expert in Professional coding and existing workflows to staff and partner departments.
• Responsible to conduct regular QA reviews to identify coding errors and trends, communicate findings, and monitor cases for improvement. Works closely with the Professional training and education team on findings and /or trends. May work with audit educator to educate and train internal staff or the vendors, as needed.
• Capable of coding all Professional coding specialties (4+ specialty types as defined by the department) and maintain a minimum of 95% overall coding quality score in diagnostic, procedural, and modifier code selection. May need to production code based on department needs, and codes cases on a regular basis to reduce outstanding AR.
• Participates and seeks out career development activities by reading journals, coding articles, researching procedures and/or disease processes to ensure appropriate code selection, regularly attends coding education sessions and leads learning circles. Shares information with team members and works in conjunction with audit educators to mentor and provide coding support.
• Prioritizes coding workload appropriately by focusing efforts on cases and service lines with the potential to impact department goals. Mentors and provides guidance to fellow team members on prioritizing their coding workload, when needed, to improve AR.
• May serve in a lead capacity to provide support to the staff in absence of their supervisor. May cover for the vendor coordinator.
• Performs all other duties or special projects requested by manager.
• Exhibits enthusiasm for the profession, embraces educational opportunities and department support offered and remains engaged in the goals and vision of the department. Role models the professional standards of behavior and encourages staff to do the same.

Qualifications

EDUCATION

• Bachelors degree preferred in a health-related field. Coursework, preferably college level, in anatomy and physiology, medical terminology, pathophysiology, and disease process strongly preferred.

EXPERIENCE

• Five (5) or more years of progressive coding experience in Professional Coding.
• Must be fully proficient in a majority of the professional specialties as defined within the department.
• Prior experience in Epic required.
• Audit educator and /or coding lead support experience strongly preferred.

LICENSURE

• CPC or CCS-P credential required. CCC and/or CIRCC preferred. Additional relevant coding certifications preferred. AAPC approved facilitator and/or education preferred.

SPECIAL SKILLS

• Must have extensive knowledge of all service lines within Professional coding, includes all official coding guidelines and internal workflows. Must be able to resolve coding claim edits and have a general understanding of the revenue cycle. Advanced knowledge of Excel is required, for the ability to track, trend, and report. Must be able to create dashboards, presentations, educational coding tools and procedures with the use technology and /or reporting to ensure coding compliance, proficiency and adherence to KPI targets.

YNHHS Requisition ID

195408