Lead Coder

Job not on LinkedIn

🕒 April 2

🤠 Texas – Remote

🤠 Texas – Remote

⏰ Full Time

🟠 Senior

🏥 Medical Billing and Coding

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<Undefined>

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2006

🛍️ eCommerce

🏪 Marketplace

🌐 Web 3

eCommerce • Marketplace • Web 3

<Undefined> is a domain listing service offering the domain undefined. es for sale. They provide potential buyers with options to bid or make an offer for the domain, with assistance from domain experts. The company emphasizes safe payments and a fast transfer service to enable users to start their business swiftly.

📋 Description

• In compliance with established guidelines, reviews supporting documentation to ensure accurate coding assignments (ICD, CPT, HCPCS) in support of third party payer, NCCI guidelines and THR/THPG policies. • Maintains documentation to record/track discrepancies for applicable provider specialties. • Monitor and assist charge capture and/or denial coding staff as needed. • Monitor CRD charge capture/denial WQs and assist in resolving system issues preventing charges from clearing the WQs (e.g. misrouting, charges not dropping, edits not functioning as expected). • Monitor coding discrepancy logs to identify trends impacting coding. • Performs root cause analysis and creates action plans for issues impacting coding quality or established KPI metrics. • Participates in special projects and completes other duties as assigned. • Serves as a subject matter expert, providing direction to less experienced staff. • May assist with training, auditing, and/or reviewing productivity and quality rates under the leadership of department management. • Respond to requests for assistance from inter-departmental teams, external vendors, providers and operations as well as addressing escalated questions pertaining to coding and quality distribution lists. • Process requests to force override system held charges, charge corrections, void charges, merge charges, deferred charges and write offs. • Support designated meetings when required by department management (e.g., Optimization, Edits, Lab, Denial, Payor Escalations, CRD Policy & Procedures, etc.) by preparing documentation, communicating updates, minutes, following action items and/or serving as proxy.

🎯 Requirements

• H.S. Diploma or Equivalent REQUIRED • Bachelor's Degree Related field • 4 Years Coding, denials, and/or AR experience in lieu of degree REQUIRED • 5 Years Coding and/or Denials experience REQUIRED • CPC - Certified Professional Coder Upon Hire REQUIRED or CCS-P - Certified Coding Specialist - Physician-based Upon Hire REQUIRED • Other Specialty certification such as CGSC, COSC, CCC, CPB, CPPM, CHONC, CFPC, CPMA, etc. Upon Hire preferred • Extensive understanding of health insurance and medical coding requirements. • Extensive knowledge of third party billing regulations, professional operations, and third party payer requirements. • Must possess strong written & verbal communication skills, good interpersonal skills. • Must be detail oriented and have strong organizational skills. • Must possess a strong work ethic and a high level of professionalism. • Must have advanced computer skills (e.g., Excel, Power Point, Word, Outlook, OneNote, SharePoint) • Must possess strong analytical, research & reporting skills • Must be comfortable leading people/demonstrating leadership qualities in alignment with THPG promise behaviors

🏖️ Benefits

• 401k • PTO • medical • dental • Paid Parental Leave • flex spending • tuition reimbursement • Student Loan Repayment Program