LCMC Health
Overview
Lead Coder, Hospital OP Coding at LCMC Health Role focuses on coding outpatient types (same-day surgery, ancillary, ambulatory and provider-based clinics). Includes mentoring, training and cross-training coding staff, including newly hired staff. Responsible for reviewing documentation to assign appropriate CPT/HCPCS and ICD-10-CM-PCS codes for hospital and professional (physician) services for Inpatient and Outpatient records. Responsibilities
Proficiently navigate the patient health record and systems to accurately determine diagnosis and procedures codes, MS-DRGs and APCs. Code complex outpatient or inpatient cases using encoder software, Computers Assisted Coding (CAC), and reference materials to assign ICD-10-CM/PCS, CPT/HCPCS, MS-DRG, APR-DRG, POA, SOI, ROM, APC, and all required modifiers. Validate charges by comparing charges with health record documentation as necessary. Use retrospective edit tools to address coding and/or documentation issues related to submitted diagnosis and procedure information from the health record. Communicate effectively with clinical staff, physicians and office staff and Clinical Documentation Improvement Specialist regarding documentation issues or needs related to inpatient, outpatient, or ambulatory coding. Identify concerns and notify appropriate leadership for resolution; provide resolution to moderate to complex problems. Track issues (missing documentation, charges, physician queries) requiring follow-up to facilitate timely coding. Consistently meet or exceed coding quality and productivity standards established by the coding department. Adhere to confidentiality requirements related to release of patient information. Maintain up-to-date knowledge of changes in coding and reimbursement guidelines and regulations. Perform other duties as assigned by leadership. Maintain working knowledge of applicable coding and reimbursement laws and regulations, the Code of Ethics, and related policies and procedures to ensure ethical and professional behavior. Must-Haves
Experience Qualifications
Minimum three (3) years of current complex outpatient and inpatient coding (required). Education Qualifications
Required: AHIMA- or AAPC-approved coding program. Required: Associate degree in health information management or related field or an equivalent combination of education and experience. Licenses and Certifications
Certification Name: Certified Coding Specialist (CCS) — Required; Issuer: AHIMA or AAPC. Certification Name: Certified Inpatient Coder (CIC) — Required; Issuer: AHIMA or AAPC. Certification Name: Certified Professional Coder (CPC) — Required; Issuer: AHIMA or AAPC. Certification Name: RHIA/RHIT — (If applicable); Issuer: AHIMA or AAPC. Internal staff who are not certified must obtain medical coding certification within twelve months through an approved LCMC coding program (Required). Skills And Abilities
Extensive knowledge of medical terminology, anatomy and physiology, diagnostic and procedural coding, and MS-DRG/APC grouping. Experience with encoding/grouping software and enterprise systems. Strong computer literacy and basic email/internet navigation skills. High ethical standards; knowledge of ICD-10-CM/PCS, CPT/HCPCS, MS-DRG, APR-DRG and APC guidelines. Knowledge of PPS for inpatient, outpatient, ambulatory and provider-based encounters; hospital and professional coding including provider-based billing. Familiarity with Joint Commission and CMS documentation regulations; experience with concurrent coding reviews. Privacy and security regulation knowledge; confidentiality and release of information practices. Experience in training and identifying learning needs for coding staff. Strong analytical, problem-solving, and communication skills; ability to organize, prioritize, and adapt to change; effective collaboration with physicians and management. Work Shift
Variable Hours (United States of America) Employer Information
LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law. The above job summary is intended to describe the general nature and level of the work being performed. This is not an exhaustive list of duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary. Additional Notes
To get started, complete the application accurately. Incomplete applications may be eliminated due to missing information. Information on your application may be used to verify previous employment and background. Applications are inactive after 6 months and require a new application to be completed. Proof of citizenship or immigration status may be required to verify right to work in the United States.
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Lead Coder, Hospital OP Coding at LCMC Health Role focuses on coding outpatient types (same-day surgery, ancillary, ambulatory and provider-based clinics). Includes mentoring, training and cross-training coding staff, including newly hired staff. Responsible for reviewing documentation to assign appropriate CPT/HCPCS and ICD-10-CM-PCS codes for hospital and professional (physician) services for Inpatient and Outpatient records. Responsibilities
Proficiently navigate the patient health record and systems to accurately determine diagnosis and procedures codes, MS-DRGs and APCs. Code complex outpatient or inpatient cases using encoder software, Computers Assisted Coding (CAC), and reference materials to assign ICD-10-CM/PCS, CPT/HCPCS, MS-DRG, APR-DRG, POA, SOI, ROM, APC, and all required modifiers. Validate charges by comparing charges with health record documentation as necessary. Use retrospective edit tools to address coding and/or documentation issues related to submitted diagnosis and procedure information from the health record. Communicate effectively with clinical staff, physicians and office staff and Clinical Documentation Improvement Specialist regarding documentation issues or needs related to inpatient, outpatient, or ambulatory coding. Identify concerns and notify appropriate leadership for resolution; provide resolution to moderate to complex problems. Track issues (missing documentation, charges, physician queries) requiring follow-up to facilitate timely coding. Consistently meet or exceed coding quality and productivity standards established by the coding department. Adhere to confidentiality requirements related to release of patient information. Maintain up-to-date knowledge of changes in coding and reimbursement guidelines and regulations. Perform other duties as assigned by leadership. Maintain working knowledge of applicable coding and reimbursement laws and regulations, the Code of Ethics, and related policies and procedures to ensure ethical and professional behavior. Must-Haves
Experience Qualifications
Minimum three (3) years of current complex outpatient and inpatient coding (required). Education Qualifications
Required: AHIMA- or AAPC-approved coding program. Required: Associate degree in health information management or related field or an equivalent combination of education and experience. Licenses and Certifications
Certification Name: Certified Coding Specialist (CCS) — Required; Issuer: AHIMA or AAPC. Certification Name: Certified Inpatient Coder (CIC) — Required; Issuer: AHIMA or AAPC. Certification Name: Certified Professional Coder (CPC) — Required; Issuer: AHIMA or AAPC. Certification Name: RHIA/RHIT — (If applicable); Issuer: AHIMA or AAPC. Internal staff who are not certified must obtain medical coding certification within twelve months through an approved LCMC coding program (Required). Skills And Abilities
Extensive knowledge of medical terminology, anatomy and physiology, diagnostic and procedural coding, and MS-DRG/APC grouping. Experience with encoding/grouping software and enterprise systems. Strong computer literacy and basic email/internet navigation skills. High ethical standards; knowledge of ICD-10-CM/PCS, CPT/HCPCS, MS-DRG, APR-DRG and APC guidelines. Knowledge of PPS for inpatient, outpatient, ambulatory and provider-based encounters; hospital and professional coding including provider-based billing. Familiarity with Joint Commission and CMS documentation regulations; experience with concurrent coding reviews. Privacy and security regulation knowledge; confidentiality and release of information practices. Experience in training and identifying learning needs for coding staff. Strong analytical, problem-solving, and communication skills; ability to organize, prioritize, and adapt to change; effective collaboration with physicians and management. Work Shift
Variable Hours (United States of America) Employer Information
LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law. The above job summary is intended to describe the general nature and level of the work being performed. This is not an exhaustive list of duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary. Additional Notes
To get started, complete the application accurately. Incomplete applications may be eliminated due to missing information. Information on your application may be used to verify previous employment and background. Applications are inactive after 6 months and require a new application to be completed. Proof of citizenship or immigration status may be required to verify right to work in the United States.
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