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Lead Coding Integrity Analyst
Lehigh Valley Health NetworkLead Coding Integrity Analyst overseeing coding integrity for health network in Pennsylvania. Providing documentation and coding advice related to Medicare and billing requirements.
About the role
Key responsibilities & impact- 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
What you’ll need- 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
Comp & perks- Health insurance
- 401(k) matching
- Flexible work hours
- Paid time off
- Remote work options
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
ICD-10CPT codingmedical terminologyanatomyphysiologypathophysiologycoding guidelinesbilling analysisdata analysiscoding auditing
Soft Skills
multitaskingidentifying areas of opportunityarticulating changesfacilitating changesprioritizing tasksrelationship buildingcommunication
Certifications
CCS-PCPC