Lead Medical Coder- Navigant- Remote Location
Job ID: 10815
Location: Remote Location
Full/Part Time: Full-Time
Navigant Business Process Management unites the strengths of four category-leading companies to address the complexities of today’s healthcare system. We design, develop and implement integrated, patient-centered solutions for sustained improvements in performance and profitability, working collaboratively across a spectrum of customers that encompasses hospitals, health systems, physician practice groups and payers.
The Health Information Lead Coder is responsible for accessing and coding client records by utilizing ICD-10-CM/PCS and CPT coding classification systems. This position will also act as a liaison to coordinate specific client assignments and guidelines between Coder and client. The Lead Coder shall report directly to Coding Manager and will perform any and all related job duties as assigned.
- Computer Literacy.
- Good Communication Skills.
- High level of productivity.
- HIPPA compliant work stations.
- Advanced Coding Skills, ICD-10-CM, PCS and CPT.
- Working knowledge of governmental regulations relating to coding.
- Ability to work independently.
- Working knowledge of Protected Health Information.
- Maintains a working knowledge of ICD-10-CM, PCS and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing.
- Demonstrates the ability to perform quality coding and answer questions on inpatient/outpatient surgery, clinic, emergency room, Ancillary.
- Provide training/instruction for new coders on assigned facility. Training to include facility specific coding/abstracting guidelines, encoder and EMR functionality.
- Responsible for following facility specific policies and procedures
- Provide daily support to coder on as needed basis to answer questions relating to the facility.
- Reviews the coding and pending queues daily to ensure all charts are worked timely and notifies administrative staff in the event they cannot meet the twenty-four hour turn around standard.
- Facilitates daily work assignments to coders and works with Operations Manager to resolve coder questions and issues.
- Sends a daily queue status report and communicates to the facility as necessary.
- Responsible for working directly with the IQC staff to ensure quality standards are being met for each facility.
- Coaches team members to improve their performance with some input and direction from management. Escalates performance issues as appropriate.
- Quality reports must be reviewed, and necessary corrective action plan should be communicated to the IQC manager within five working days of receipt of the monthly quality report.
- Works well with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services.
- Communicates problems or coding principle discrepancies to your supervisor immediately.
- Leads coder calls and participates in client meetings.
- Works coding/billing edits as required.
- Reviews documentation and adds modifiers as required based on coding guidelines.
- Appropriately abstracts all data elements as required by client facility.
- Assures that all services documented in the patient’s chart are coded with appropriate ICD-10 and CPT codes. When services/diagnoses are not documented appropriately, seeks to attain proper documentation in a timely manner according to facility standards.
- Queries physicians whenever there is conflicting, ambiguous, or incomplete information in the medical record regarding any significant reportable condition or procedure. Insures that the coding team follows query policy and conducts themselves in a professional manner.
- Achieves and maintains 95% accuracy in coding while maintaining a high level of productivity. Accuracy will be monitored during monthly reviews either within the facility, EMR/imaging system.
- Ability to maintain 95% average productivity standards
- Ensures team maintains average productivity standards as follows: Inpatients 3-4 charts per/hr, outpatient surgery 4-6 charts per/hr, emergency room/clinics 25-30 charts per/hr, emergency room with E/M 20-25 charts per/hr, ancillary/diagnostic 25-30 charts per/hr.
- Complete monthly productivity report by coder and client
- Review productive and non-billable hours to ensure maximum utilization & efficiency
- Validate time in ADP to People Soft to ensure all employee hours are correct and ensure the correct task codes have been used.
- Charts that require re-bills are to be corrected and communicated to the facility daily for the rebill process. See re-bill policy in facility guidelines.
- Provides accurate answers to physician’s/hospitals coding and/or billing questions within eight hours of request.
- Report coder downtime immediately to the administrative staff
- Work closely with client IT departments and Navigant IT to resolve system issues
- Responsible reviewing and updating Client Portal, and using the information contained on the Portal as a daily tool to correctly code and abstract for each facility.
- Responsible for checking email system at least every two hours during work hours.
- Communication in emails should always be professional (reference e-mail policy).
- Must maintain their current professional credentials
- Lead Coder is to maintain a working knowledge of all Coding Clinic Guidelines.
- Complete CE education provided by Navigant and turns in certificates timely.
- Enters hours worked daily into ADP e-Time and Navigant time keeping People Soft system.
- Responsible for maintaining HIPAA compliant work stations (reference HIPAA work station policy)
- Responsible for maintaining patient privacy always (reference company handbook policy compliance section 105)
- Must hold one of the following credentials: (RHIT, RHIA, CCS, CPC-H, CPC-P).
- Must have three years of coding experience.
- Abide by all client policies and procedures.
- Abide by all Navigant policies and procedures.
- Personal responsibility, respect for self and others, innovation through teamwork, dedication to caring and excellence in customer service.
- Remote Workstation.
- Internet Access with DSL or Cable.
- Remote location often working from a home office base.
- Strong conceptual, as well as quantitative and qualitative analytical skills
- Work as a member of a team as well as be a self-motivator with ability to work independently
- Constantly operates a computer and other office equipment to coordinate work
- Regularly uses close visual acuity and operates computer equipment to prepare and analyze and transmit data
- Generally works in an office environment
Navigant is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information or any other basis protected by law, ordinance, or regulation.
Navigant will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
Navigant Consulting, Inc. (NYSE: NCI) is a specialized, global professional services firm that helps clients take control of their future. Navigant’s professionals apply deep industry knowledge, substantive technical expertise, and an enterprising approach to help clients build, manage and/or protect their business interests. With a focus on markets and clients facing transformational change and significant regulatory or legal pressures, the Firm primarily serves clients in the healthcare, energy and financial services industries. Across a range of advisory, consulting, outsourcing, and technology/analytics services, Navigant’s practitioners bring sharp insight that pinpoints opportunities and delivers powerful results. More information about Navigant can be found at navigant.com.