Apply on Employer Site

Datavant · 2 weeks ago

Profee Coding Lead

United States

Full-time

Remote

Mid, Senior Level

3+ years exp

Datavant is a data platform company and the world’s leader in health data exchange. They are seeking a Profee Coding Lead with a strong Ortho background to monitor coding queries, mentor staff, and ensure compliance with coding guidelines.

BiopharmaClinical TrialsData IntegrationHealth CareSoftware

No H1B

Responsibilities

Review medical record documentation to identify pertinent diagnoses/procedures requiring code assignment for profee charts and accurately code the diagnoses and procedures for reimbursement, research, and compliance with federal regulations

Query physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes

Keep abreast of coding guidelines and reimbursement reporting guidelines, bringing identified concerns to the manager for resolution

Mentor and train newly hired coders and providers, providing ongoing training for coding staff

Assist the coding manager with special coding assignments or coding tasks to resolve unbilled issues

Serve as a resource for all coding-related questions, responding promptly to requests and questions from coding staff

Promote individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff

Monitor and report all required performance measures, including the development of department goals and assistance in assessing goal attainment

Conduct and recommend training to improve team performance

Ensure management is informed of any employee personnel issues

Function as a resource to employees for questions and additional training

Assist management in monitoring staff's KPIs, timekeeping, and schedules

Qualification

Profee coding experienceCoding Certification (AAPC/AHIMA)ICD-10 knowledgeBilling/denial experienceAnalytical skillsHuman anatomy knowledgeCoding compliance understandingEducation/Training experienceSupervisory experienceEffective communicationCritical thinking

Required

3+ years of Profee coding experience

Previous supervisory/team lead experience

Coding Certification from the American Association of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA) required

High School Diploma or GED required

Proficient knowledge of ICD-10 and Profee coding guidelines

Strong billing/denial experience

Effective oral and written communication skills

Strong analytical skills to interpret data

In-depth knowledge of human anatomy, medical terminology, and surgical terminology

Strong critical thinking skills and decision-making abilities

Comprehensive understanding of coding compliance policies, coding guidelines for multiple specialties, and insurance payor policies