Coding Lead Specialist - PAA Billing

The Lead Coding Specialist is responsible for assisting the department Coding Specialists and Apprentice with analysis and review of medical records; accurate coding and abstracting medical records for the purpose of reimbursement, research and compliance with federal regulations by diagnosis, assignment of ICD-10 and CPT codes for inpatient and outpatient medical services as indicated. Also responsible for researching newly identified diagnoses and/or procedures for code assignments and performing related miscellaneous duties as assigned. The Lead Coding Specialist will act as interim in the absence of the Coding Supervisor.[Hybrid - Onsite Mondays][CPC or CCS Certification required][7 years of Coding experience required]The moment you walk through our doors, you feel it. When you meet our patient families, you believe it. And when you talk with anyone who works here, you want to be part of it. Welcome to Nationwide Children’s Hospital, Where Passion Meets Purpose.Here, Diversity, Equity and Inclusion are integrated into our core values and practices. We are passionate about building, sustaining and evolving an inclusive and equitable environment. We are seeking individuals who live these values and want to share their experiences and efforts in support of our collective mission. We’re 14,000 strong. And it takes every one of us to improve the lives of the kids we care for, and the kids around the world we’ll never meet. Kids who live healthier, fuller lives because of the knowledge we share. We know it takes a Collaborative Culture to deliver on our promise to provide the very best, innovative care and to foster new discoveries, made possible by the most groundbreaking research. Anywhere.Ask anyone with a Nationwide Children’s badge what they do for a living. They’ll tell you it’s More Than a Job. It’s a calling. It’s a chance to use and grow your talent to make an impact that truly matters. Because here, we exist simply to help children everywhere.Nationwide Children’s Hospital. A Place to Be Proud.

· Utilizing the Ingenix Encoder Pro system, CPT, and ICD-10-CM coding books assigns CPT and ICD-10-CM codes to inpatient medical services or charges.

· Assists Coding Supervisor with training and orientation of new coding staff.

· Assists Coding Supervisor with the collection of employee’s productivity and prepare data as directed.

· Responsible in conjunction with the Coding Supervisor for preparing educational materials for physicians.

· Conducts ongoing and sample chart reviews of providers to assure coding accuracy and to identify missed coding opportunities

· Maintains updated knowledge of coding requirements; including continuing education and certification renewal

· Reviews and performs necessary coding and billing corrections for all insurance coding and medical necessity denials

· Assists the billing staff with coding questions

· Codes clinic and other outpatient medical services utilizing ICD-10-CM and CPT coding system.

· Consistently meets the department specific standards for quantity.

· Consistently codes 95% accuracy rate or better (quality standard)

· Utilizes Internet and other resources to research newly identified diagnosis and/or other procedures.

· Assists physicians by identifying the necessary ranges of disease or procedure codes

· Researches CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.

· Acts as a liaison between the physicians, parents and third party payers in resolving billing and reimbursement accuracy.

· Performs other duties as assigned.

Minimum Qualifications;

High school diploma or equivalent

Associate Degree preferred

CPC or CCS Certification required

Good working knowledge of medical terminology and anatomy

Must possess high degree of professional competency for coding, accuracy in all details, and must possess a self directed work ethic.

Excellent customer service skills.

Demonstrated ability to articulate in front of physicians and Senior Leadership.

Strong problem-solving, collaboration and interpersonal skills

Ability to work effectively and professionally under pressure

Ability to maintain and establish strong working relationships with physicians and support staff

Intermediary skills in MS Office: Word, Excel, PowerPoint and Outlook required

Previous Professional coding experience (7+ years) with documented education in anatomy, physiology, and medical terminology required. Pediatric coding and billing a plus.

Ability to handle multiple tasks and priorities and deadlines.

Analytical and organizational skills a must for analyzing clinical information and data

Effective communication and interpersonal skills required with ability to work with physicians and other caregivers regarding coding issues.

The above list of duties is intended to describe the general nature and level of work performed by people assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the people so classified, nor is it intended to limit or modify the right of any supervisor assign, direct and control of the work of employees under his/her supervision. Requisition ID: 2023-44354 External Company Name: Nationwide Children's Hospital External Company URL: https://external-nationwidechildrens.icims.com/jobs/intro Street: 3700 Corporate Drive