HIM Inpatient Coding Lead-100% remote-Excludes some states
Northeast Georgia Health System, Inc.

Gainesville, Georgia

Posted in Health and Safety


This job has expired.

Job Info


Work Shift/Schedule:
8 Hr Morning - Afternoon

Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.

About the Role:

Posting Details

Job Summary

Responsible for providing operational and knowledge support related to Coders. Responsible for mentoring and training Coders, including new Coder training, maintaining workflow activities, coaching, keeping abreast of new educational requirements and opportunities for Coding. Assists and is the Coding Manager's "wingman" and covers when necessary. Assists with monitoring productivity and coding quality of Coders and HIM Education Auditor. Will assist in facilitating with other departments, Physicians, hospital personnel and outside health care providers. Responsible and accountable for coordinating all daily work assignments for Coders. HIM Coding Lead will assist with Coding work as needed.

Minimum Job Qualifications

  • Licensure or other certifications: Certified Coding Specialist (CCS) required.
  • Educational Requirements: High School Diploma or GED.
  • Minimum Experience: Five (5) to seven (7) years of hospital based coding experience to include complex CPT surgical coding and/or advanced ICD-10-CM-PCS coding.
  • Other:

Preferred Job Qualifications
  • Preferred Licensure or other certifications:
  • Preferred Educational Requirements: Associates Degree.
  • Preferred Experience: Experience in Teaching facilities and/or Trauma Facilities.
  • Other:

Job Specific and Unique Knowledge, Skills and Abilities
  • Must pass an advanced coder competency exam with a minimum score of 95% demonstrating proficiency in inpatient and/or outpatient coding of all service types
  • Advanced knowledge of anatomy & physiology, disease processes, medical terminology, pharmacology, and surgical procedures/techniques
  • Effective organizational and multi-tasking skills
  • Good interpersonal skills. Ability to communicate both verbally and in written form necessary.
  • Must possess a high level of accuracy and attention to detail
  • Proficient use of electronic health records (Epic) and encoder systems (3M)
  • Advanced in the use of Microsoft Word, Excel, and Powerpoint including the ability to create reports and graphs to report quality and productivity etc
  • Must maintain patient and employee confidentiality at all times
  • Advanced knowledge of Coding Resources and demonstrated proficiency in using the appropriate resources
  • Ability to test, analyze, troubleshoot and isolate complex problems
  • Advanced knowledge of billing requirements and the ability to resolve the most complex edits
  • Ability to audit and validate the accuracy of ICD-10-CM-PCS and CPT codes, DRGs, and APCs
  • Ability to mentor and to provide constructive feedback
  • Understanding of Revenue Cycle and Regulatory Guidelines such as CMS, EMTALA, and HIPAA
  • Requires critical thinking, analytical, work prioritization and organizational skills
  • Ability to maintain close concentration during performance of tasks with frequent interruptions

Essential Tasks and Responsibilities - Leadership (50%)
  • Assists Coding Manager with maintaining the workflow activities of coders.
  • Mentors and trains coders, including new coders and reports progress to Coding Manager.
  • Provides assistance to coders with questions.
  • Is the Coding Manager's "Wingman" and maintains wingman at all times, and covers for Coding Manager if needed.
  • Creates a trusted work environment for employees through team building, coaching, constructive feedback, work delegation, personal example, and goal setting that encourages creativity, open dialogue on work issues, professional growth, and a consistent, high level of performance; encourage and support employee decision making within his or her scope of responsibilities.
  • Performs daily tasks in EPIC, Outlook, Microsoft Office.
  • Assists Coding Manager with productivity and quality goal creation, New Employee Checklist, Competency Skills Checklist, and departmental policies and procedures for Coders.
  • Audits a daily percentage of all Coders work.
  • Epic and Other Systems Testing/Upgrades, which may include being a Super User for Said System.
  • Reviews and tracks daily production logs/standard work sheets for Coders. Records in productivity spreadsheet.
  • Develops and maintains training material for initial and ongoing training for Coders.
  • Responsible for participating in leading daily Tier 1 huddle for Coders.
  • As a remote employee must be able to organize work to ensure goals are met. Identifies and escalates any obstacles to fulfilling job responsibilities.
  • Attends and actively participates in huddles/meetings/committees as required and appropriate.
  • Creates, maintains, and updates all standard work procedures and worksheets for Coders.
  • Reports deviations of departmental performance to Coding Manager with action plan for resolution.
  • Assists with development and implementation of departmental procedure and service levels related to productivity and quality.
  • Identifies process improvement opportunities through root cause analysis, develop action plan, and report results.
  • Other duties as required / assigned.

Essential Tasks and Responsibilities - Leadership (25%)
  • Reviews daily Audit work queue assignments and determines the validity of coding by auditing the documentation, coding, and DRG Grouper/APC assignments of each claim.
  • Audits each claim according to the coding Guidelines and reimbursement reporting requirements unique to the individual payer.
  • Utilizes the appropriate resources and references to justify the correct codes.
  • Discusses findings with coders and escalates to Coding Manager as necessary.
  • Identifies documentation deficiencies that contribute to coding errors and escalates to Coding Manager.
  • Identifies opportunities to capture Hierarchical Condition Category codes.
  • Identifies opportunities to increase Severity of Illness and Risk of Mortality.
  • Establish a strong working relationship with Clinical Documentation Improvement to insure that reimbursement and quality measures are optimized.
  • Provides education to physicians related to documentation necessary to correctly abstract and code patient accounts.
  • Provides coding related education to other departments as needed.
  • Must be able to represent coding in meetings.
  • Identifies trends in coding errors and provides pertinent education and training to coding staff.
  • Organizes work to ensure that accuracy rates and coder education are current and identifies obstacles to fulfilling responsibilities.
  • Collaborates with Coding Management to improve future coding compliance and achieve optimal reimbursement.

Essential Tasks and Responsibilities - Coding(25%)
  • As necessary, assigns and sequences diagnosis and procedure codes using appropriate classification systems and official coding guidelines to insure that DRG (Diagnosis-related group) or APC (Ambulatory Payment Classification) assignment is correct. Codes inpatient (IP), same day surgery (SDC), observation (OBS), emergency department (ED), recurring (RCR), and clinical (CLI) records, including the assignment of ICD-10-CM, Procedure Categories, modifiers (when applicable) and HCPCS/CPT codes across multiple facilities and possible E/M levels.
  • Reviews work queue assignments and prioritizes work by date, charges and payors to meet revenue cycle goals.
  • Reviews documentation and possibly charges to correctly assign outpatient procedure codes
  • Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current.
  • Initiates physician query in compliance with Company policy when appropriate.
  • Reassign accounts with missing or incomplete documentation/charges to appropriate work queues.
  • Correctly abstracts discharge disposition, performing physician, and procedure dates. Corrects discharge disposition based on payer requirements.
  • In- depth knowledge of coding and charging requirements necessary to resolve billing edits at time of coding.
  • Works with revenue cycle to resolve issues related to billing.
  • Ability to audit coding quality and provide feedback on an as needed basis.
  • Must maintain coding certification, continue to work towards knowledge base growth by cross-training to learn other patient types and attend in-service training as required.

Physical Demands
  • Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time
  • Weight Carried: Up to 20 lbs, Occasionally 0-30% of time
  • Vision: Moderate, Frequently 31-65% of time
  • Kneeling/Stooping/Bending: Occasionally 0-30%
  • Standing/Walking: Occasionally 0-30%
  • Pushing/Pulling: Occasionally 0-30%
  • Intensity of Work: Occasionally 0-30%
  • Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding

Environment and Working Conditions
  • OSHA Category II: Job classifications in which normal duties do not reasonably anticipate exposure to blood or other potentially infectious or hazardous materials. Contact with blood may occur in an emergency.

Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals.

NGHS: Opportunities start here.

Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.


This job has expired.

More Health and Safety jobs


Rehabilitation Institute of Chicago
Chicago, Illinois
Posted about 1 hour ago

Rehabilitation Institute of Chicago
Chicago, Illinois
Posted about 1 hour ago

Rehabilitation Institute of Chicago
Chicago, Illinois
Posted about 1 hour ago

Get Hired Faster

Subscribe to job alerts and upload your resume!

*By registering with our site, you agree to our
Terms and Privacy Policy.