UNT Health Fort Worth · 1 week ago
Coding Team Lead
UNT Health Fort Worth is part of the University of North Texas System, which is dedicated to transforming lives through education. The Coding Team Lead is responsible for ensuring accurate medical coding and billing for services provided under contracts with the Federal Bureau of Prisons, overseeing a team of coders, and ensuring compliance with healthcare regulations.
EducationHealth CareNon ProfitUniversities
Responsibilities
Serve as Team Lead principally responsible for reviewing inpatient, outpatient, long term care facility and provider claims submitted by Correctional Health Network facilities and providers under CMD contracts
Review and validate accuracy and completeness of medical claims and assigned Diagnostic Related Group Rates (DRG) under Hospital Inpatient Prospective Payment System, Ambulatory Payment Classification (APC) under Outpatient Prospective Payment System, and Long-Term Care DRG under Long Term Care Hospital Prospective Payment System based on supporting documentation
Assess all available patient medical records from multiple resources (electronic and hard copy) and verify medical coding to ensure accuracy of charges are consistent with the level of service, Medicare regulatory guidelines, and CMD contract terms and conditions. Evaluate appropriateness of assigned lCD 10, HCPCS and CPT codes, APC, DRG, LTCH-DRG, admission assignments and modifier usage
Utilize NextGen Enterprise Practice Management (EPM) system to develop and maintain reporting tools for tracking and reconciling delinquent accounts and obtain needed and/or modified claims in a timely manner
Develop action plans to address potential areas of process improvement and/or noncompliance. Create and provide education to Correctional Health Network facilities and providers based on claims review, when applicable
Assist with developing and/or modifying new or existing policies and procedures based upon Medicare regulatory developments and compliance monitoring as well as auditing activities, processes and findings
Qualification
Required
Bachelor's degree or equivalent combination of education and experience, and three (3) years of coding experience
CPC or CCS-P coding certification required
In-depth knowledge of ICD-9-CM, ICD-10-CM, HCPCS, and CPT coding systems and guidelines, with the ability to apply them accurately across various patient records
Solid understanding of federal and state healthcare regulations, including HIPAA, and the ability to ensure coding practices comply with these regulations
Knowledge of EHR systems and their integration with coding processes, along with the ability to navigate and extract necessary data from EHR systems for accurate coding
Understanding of the relationship between coding and billing, as well as payer-specific requirements, to ensure accurate reimbursement
Strong ability to analyze clinical data and medical records to determine appropriate coding, ensuring both accuracy and efficiency
Excellent attention to detail to ensure all diagnostic and procedural codes are accurately assigned, minimizing errors in data entry and claims processing
Ability to lead and motivate a coding team, provide training and feedback, and foster a collaborative and productive work environment
Strong organizational skills to manage multiple tasks and deadlines, with the ability to adapt quickly to changes in coding guidelines, system updates, and regulatory requirements
Inpatient Coding Certification by the American Academy of Professional Coders (AAPC) or other accredited professional coding organization
Preferred
Demonstrated experience in working with correctional health care service contracts
Demonstrated capability in utilizing NextGen Enterprise Practice Management software application
Company
UNT Health Fort Worth
UNT Health Fort Worth opened its doors in 1970 as the Texas College of Osteopathic Medicine.
Funding
Current Stage
Late StageTotal Funding
$152MKey Investors
Tarrant CountyNational Institutes of HealthBlue Cross and Blue Shield of Texas
2022-12-13Grant· $2M
2022-10-03Grant· $150M
2022-07-07Grant
Leadership Team
Recent News
2025-08-18
2025-05-05
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