Lead Coding Integrity Analyst

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🔥 1 minute ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

⏰ Full Time

🟠 Senior

🧐 Analyst

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Lehigh Valley Health Network

WebsiteLinkedInAll Job Openings

10,000+ employees

⚕️ Healthcare Insurance

Healthcare Insurance

Lehigh Valley Health Network is a comprehensive healthcare system that is now part of Jefferson Health, one of the top 15 not-for-profit health systems in the United States. It offers a wide range of medical services, including primary care, urgent care, and specialized institutes like the Lehigh Valley Topper Cancer Institute and the Lehigh Valley Heart and Vascular Institute. LVHN provides extensive care solutions, including video visits, second opinions, and a network of doctors and clinicians in numerous locations. It emphasizes education through residencies and fellowships and prioritizes patient-centric services such as lab testing and women's health care. The network also focuses on innovation, offering clinical trials and advanced therapies like CAR-T Cell Therapy.

📋 Description

• Leads the team of coding integrity analysts. • Provides documentation and coding advice related to Medicare, CMS regulations, and third-party billing requirements to the staff of LVPG. • Serves as a resource to the organization for coding as it relates to professional fee billing. • Oversees relevant edits in billing system to ensure accurate billing to all payers in a timely manner. • Manages critical data analysis; conducts research on complex documentation and coding issues and assimilates data. • Conducts coding data analysis on outpatient services billed by providers with the intent on billing/reimbursement outcomes. • Maintains the coding integrity for professional fee services rendered in facility and non-facility settings. • Tracks and trends data for recommendations of workflow and process changes. • Orchestrates communications for streamlined processing of payor rejection trends to expedite processing of accounts receivables. • Serves as a resource with regard to the rules and regulations for proper coding. • Assists revenue cycle with onboarding coding processes for new practices or major coding changes within an existing practice. • Analyzes coding trends/issues and communicates with appropriate staff for educational purposes.

🎯 Requirements

• High School Diploma/GED or coding curriculum to include medical terminology, A&P, ICD-10, and coding guidelines. • 3 years experience in professional fee coding/auditing in a multi-specialty environment. • Knowledge of medical terminology, anatomy, physiology, and pathophysiology. • Knowledge of CPT & ICD-9/ICD-10 CM coding classification systems, regulatory agency requirements, health care statistics computation, and accounting principles. • Ability to multitask, identify areas of opportunity, and articulate and facilitate changes. • Ability to prioritize tasks to expedite AR processing. • Builds strong relationships with co-workers to partner for a better outcome. • Knowledge of practice management system, EMR, and MS office applications (Word/Excel/Access). • CCS-P - Certified Coding Specialist-Physician Based AHIMA - State of Pennsylvania Upon Hire or CPC - Certified Professional Coder - State of Pennsylvania Upon Hire

🏖️ Benefits

• Health insurance • 401(k) matching • Flexible work hours • Paid time off • Remote work options