Coordinator Medical Coding/Claims (Remote) - Pediatrics Central Administration

📋 Description

• • As a Coordinator Medical Coding/Claims with a focus on Pediatrics Central Administration, you will play a pivotal role in ensuring the accuracy, efficiency, and compliance of medical coding and claims processing within a specialized pediatric department.
• • This remote position offers a 40-hour work week, providing flexibility while demanding a high level of responsibility and attention to detail.
• • A core aspect of your role will involve proactive communication with healthcare providers, serving as a crucial liaison to clarify documentation and ensure accurate coding practices.
• • You will work closely with the Pediatrics Coding Supervisors, acting as a Lead Coder and contributing significantly to both coder and physician education initiatives.
• • This includes preparing documentation, creating detailed spreadsheets, and facilitating meetings with physicians and administrators to address coding-related inquiries and provide essential feedback.
• • You will serve as a primary resource for inpatient coders, offering guidance and support, and will be instrumental in training new coders, ensuring they are up-to-date with the latest coding standards and departmental procedures.
• • A key responsibility is the performance of regular scheduled quarterly coder audits, as well as ad-hoc audits, to maintain high standards of coding quality and identify areas for improvement.
• • You will actively manage Epic Work Queues, identifying and resolving edits and other claim-related issues to ensure timely and accurate billing, which directly impacts the financial health of the department.
• • This involves reviewing coding and billing reports to pinpoint discrepancies and generating Epic tickets for system-level issues that require technical intervention.
• • You will provide critical feedback to the Coding Supervisor regarding the status of outstanding physician deficiencies and any other concerns that could impede daily workflow or billing accuracy.
• • Your role extends to managing Epic Work Queues to capture encounters that may fall outside a coder's standard view, and identifying recurring coding topics or issues to be addressed in monthly coder meetings.
• • As a Lead Coder, you will be expected to cover coding assignments as needed across multiple hospital locations and various pediatric divisions, demonstrating adaptability and a broad understanding of pediatric coding.
• • This involves meticulously reviewing medical documentation to assign the correct CPT and ICD-10 codes for Evaluation & Management (E&M) services, procedures, and tests performed by the department's physicians.
• • You will also cross-cover for the Coding Supervisor when necessary, ensuring continuity of operations and support within the coding team.
• • Maintaining your coding certification is a mandatory requirement, underscoring the importance of continuous professional development and adherence to industry standards.
• • You will be responsible for developing and implementing comprehensive plans for information intake and claims processing, from the initial submission of claims through to final payment.
• • This involves coordinating with staff to identify special project needs, gather budget information, submit necessary documentation, and implement process modifications to enhance efficiency.
• • You will continuously monitor schedules and processes, ensuring effective follow-up, system maintenance, and the timely completion of all claims.
• • A significant part of your role will involve reviewing process maps and claims history to identify bottlenecks or areas for optimization, and organizing and overseeing training courses related to process developments and system updates.
• • You will act as a key liaison between the department and external associations, vendors, and public relations offices, representing the department on matters related to coding, claims, and special project processes.
• • Your responsibilities will include providing support for testing processes, reviewing test results, and offering secretarial assistance for both routine and special projects.
• • You will also be tasked with establishing and maintaining mailing lists, filing systems, and contact source lists to ensure organized and accessible information.
• • In addition to your primary duties, you will provide essential backup support for front desk operations, including answering telephones, mailing out results, and performing other administrative tasks as needed, demonstrating a flexible and team-oriented approach.