Lead Clinical Quality Coder

  • Carolinas Healthcare System
  • Charlotte, NC, USA
  • Jun 20, 2017
Full time

Job Description

Location Details:  Arrowpoint
 
 
 
Job Summary
At Carolinas HealthCare System, we are building advanced clinical coding teams that are concurrent coding-based and/or service line-based and part of the clinical care team. 
Our Lead Clinical Coder/Auditor teammates are responsible for auditing and training these advanced teams.  Through the audit process, the Leads identify opportunities for education for Physicians and/or Coders, create educational materials and share findings with physicians and physician leaders.  Leads are also point on some very specific initiatives, e.g. 30-day mortality rates, collaborating with CDI, Nurse Navigators and Physicians to achieve whole record integrity/Documentation Excellence. Trains team members and performs coding audits. Reviews clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD9/10-CM and CPT 4 codes for billing internal and external reporting, research and regulatory compliance. Assists Coding Director, Coding Manager or Coding Supervisor with coding related functions to ensure consistent, high quality coding, MS-DRG, APC, Present on Admission, Patient Safety Indicators, Hospital Acquired Conditions and Core Measures assignments.
 
Only experienced coding professionals who are interested in being a Lead, and part of the new era advanced clinical coding/auditing should apply.

Essential Functions
 
  • Trains and orients new team members according to CHS specific guidelines while utilizing the facility encoder, HBOC and EMR.
  • Demonstrates the technical competence to use the facility encoder as it interfaces with the hospital mainframe and/or EMR in an on-site or remote setting.
  • Demonstrates proficiency with Microsoft Office Applications in using required computer systems with minimal assistance.
  • Assists Coding leadership with continuing education for all coding personnel.
  • Facilitates peer review and training for Coding personnel.
  • Prepares and performs coding audits to ensure consistent, high quality coding, MS-DRG, APC, Present on Admission, Patient Safety Indicators, Hospital Acquired Conditions and Core Measures.
  • Resolves error reports associated with billing process, identifies and reports error patterns, and, when necessary, assists in design and implementation of workflow changes to reduce billing errors.
  • Assists with rebilling accounts when necessary.
  • Coordinates flow of information between coding and other departments, which include Medical Records, Medical Audit, Patient Accounts, Performance Improvement, Corporate Compliance, RAC, DA2, Clinical Care Management and other coding reviews as requested.
  • Reviews inpatient and/or outpatient medical records to identify the appropriate principal diagnosis and procedure codes, all other appropriate secondary diagnoses and procedure codes and POA indicator for all diagnosis codes.
Physical Requirements
Must be able to concentrate and sit for long periods of time while reviewing electronic health records. Daily and weekly deadlines must be met in a fast paced office environment and/or at home environment.

Education, Experience and Certifications.
High School Diploma or GED required; Bachelor�s Degree preferred. Advanced knowledge in Medical Terminology, Anatomy and Physiology and Pharmacology. 5 years acute care facility coding and/or supervision required. Ability to work effectively as a trainer/educator while communicating effectively and patiently. Previous auditing and training experience preferred. Current RHIA, RHIT, CPC, CPC-H, CIC or CCS required plus a passing score on the CHS Coding test.
 
 
At Carolinas HealthCare System, our patients, communities and teammates are at the center of everything we do. Our commitment to diversity and inclusion allows us to deliver care that is superior in quality and compassion across our network of more than 900 care locations.
 
As a leading, innovative health system, we promote an environment where differences are valued and integrated into our workforce. Our culture of inclusion and cultural competence allows us to achieve our goals and deliver the best possible experience to patients and the communities we serve.
 
Posting Notes: Not Applicable
Carolinas HealthCare System is an EOE/AA Employer