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Coder, Lead Professional

SSM Health

Not Specified, United States Full-time in I.T. & Communications
    • Job ID 1893371

    Job Description

    It’s more than a career, it’s a calling

    MO-REMOTE

    Worker Type:

    Regular

    Job Highlights:

    Lead the way in healthcare coding as a remote Coding Lead, Professional at SSM Health. Work from the comfort of your own home while guiding a team of coding professionals, ensuring accuracy, compliance, and operational efficiency. Make a significant impact on patient care and organizational success. Join us in shaping the future of coding excellence in a dynamic and supportive work environment.

    Department: Coding

    Patient Population or Ratio: N/A

    Schedule: Full Time, Day Shift

    Starting Pay: $26.01 (Offers are based on years of experience and internal equity for this role

    Shift Differentials: Available for night, weekend, and additional shifts

    Location: Remote

    Job Summary:

    Coordinates, organizes and prioritizes the work flow activities for the coding area.

    Job Responsibilities and Requirements:

    PRIMARY RESPONSIBILITIES

    • Leads and/or coordinates shift operations, work assignments and daily priorities of assigned activities, resources, and/or associates. Serves 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.

    • Reviews medical record documentation in the electronic health record and/or on paper. Identifies, enters and posts CPT-4 and ICD-10 codes to the electronic health record. Identifies need for medical records from outside the organization and follows established procedures to obtain. 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.

    • Assists coding staff, physician, and other health care practitioners with questions regarding coding and documentation guidelines. Provides ongoing feedback based on observations from coding physician/provider documentation. Assists in educational needs of coding staff based on these conversations and questions.

    • 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.

    • Partners with follow-up department to analyze payer updates affecting/resulting in coding denials and applies knowledge to assist in correction, submission, and payment of claims. Tracks denials and reports trends to leadership. Provides feedback and guidance to coders and providers when there are recurring issues or new trends.

    • Is watchful for charge review, claim edit, and coding-related denial trends and shares trends with supervisor, managers, and team members to facilitate root cause analysis and continuous process improvement. Assists coding teammates with coding questions, charge review, claim edits, payer requirements, and clarification of policies, procedures, and processes where needed.

    • Performs other duties as assigned.

    EDUCATION

    • High school diploma or equivalent

    EXPERIENCE

    • Three years’ experience

    PHYSICAL REQUIREMENTS

    • Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.

    • Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.

    • Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.

    • Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.

    • Frequent keyboard use/data entry.

    • Occasional bending, stooping, kneeling, squatting, twisting and gripping.

    • Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.

    • Rare climbing.

    Work Shift:

    Day Shift (United States of America)

    Job Type:

    Employee

    Department:

    Scheduled Weekly Hours:

    40

    SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status , or any other characteristic protected by applicable law. Click here to learn more. ()

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