Physician Billing Coding Lead

Ann & Robert H. Lurie Children’s Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children’s Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report.

680 Lake Shore Drive

Summary:

The Pro-Fee Coding Lead will be responsible for reviewing medical documentation and assigning CPT and ICD-10 for various department of the organization. The Pro-Fee Coding Lead will work collaboratively with the Coding Manager, Physician Billing to maintain day-to-day coding operations and various projects and duties assigned.

Essential Job Functions:

•    Performs coding functions as needed for Lurie/Outreach Locations.
•    Monitors coder’s productivity by collaborating with Coding Manager to meet designated productivity and quality benchmarks.
•    Resolves questions, issues and patient disputes with third party payors, billing coordinators, compliance auditors, external billing company and denial management team that pertain to coding.
•    Prepares department coding feedback materials based on trends and issues identified via Coding WQ’s and coding denial trends.
•    Works with Coders and Audit Manager to resolve denials, identify trends and implement process improvements to increase clean claim rate and improve denial recovery rate.
•    Collaborates with Coding Manager to improve Charge Review Work queues workflow thru various WQ improvement initiatives.
•    Collaborates with Coding Manager regarding content for Coders Monthly Meeting including preparing education materials, room reservation and other tasks requirements.
•    Collaborates with Coding manager to perform and complete revenue cycle coding projects
•    Develops and maintains division specific coding protocols.
•    Assists Coding Manager with employee time management on a weekly basis including staffing coverage.
•    Assigns appropriate ICD-10-CM diagnosis code(s), CPT procedure codes and modifiers using coding conventions, guidelines and payor specific requirements.
•    Abstract and compile data from medical records for appropriate optimal reimbursement.
•    Works actively with physicians to initiate corrections and resolve discrepancies in coding and documentation.
•    Works collaboratively with physicians to assure accurate and timely submission of claims.
•    Provides feedback at division meeting around documentation and coding. 
•    Submits help desk tickets and CIS for coding and collaborates with IM for resolution.
•    Collaborates with Coding Manager on month end close numbers for coding.
•    Provides regular communication and education to providers and other clinical teams as indicated.
•    Acts in the capacity of liaison to providers, managers and other coding team members.
•    Ensures that all charges are submitted accurately and in a timely manner.
•    Works collaboratively with Compliance Auditors to identify trends, billing opportunities and physician education needs.

•    Performs job functions adhering to service principles with customer service focus of innovation, service excellence and teamwork to provide the highest quality care and service to our patients, families, co-workers and others.
•    Performs other related duties as assigned.

Knowledge, Skills, and Abilities:

•    Minimum Of Associate Degree is Required. High School Diploma required.
•    Coding credentials required such as RHIT, RHIA, CPC, CCS-P and other surgical coding credentials. 
•    Requires  3-5 years coding work experience.
•    Working and performance knowledge for divisions within the assigned coverage area preferred
•    Management and Project Management preferred
•    Demonstrates thorough knowledge of CPT and ICD-10-CM coding.
•    Maintains a thorough understanding for medical record practices, standards, regulations, Joint Commision on Accreditation of Health Organizations (JCAHO) and Illinois Medicaid coding and reporting requirements.
•    Demonstrates understanding of medical terminology, anatomy and physiology and coding classification systems and is able to apply this knowledge in determining appropriate physician coding.
•    Demonstrates the ability to communicate effectively with providers, co-workers and managers.
•    Demonstrates the ability to work independently and balance multiple priorities.
•    Demonstrates the ability to use multiple types of computer software (i.e., Word, Excel, EPIC, 3M, SharePoint, etc.).
 

Education

Associate's Degree (Required)

Benefit Statement

For full time and part time employees who work 20 or more hours per week we offer a generous benefits package that includes:

Medical, dental and vision insurance

Employer paid group term life and disability

Employer contribution toward Health Savings Account

Flexible Spending Accounts

Paid Time Off (PTO), Paid Holidays and Paid Parental Leave

403(b) with a 5% employer match

Various voluntary benefits:

• Supplemental Life, AD&D and Disability

• Critical Illness, Accident and Hospital Indemnity coverage

• Tuition assistance

• Student loan servicing and support

• Adoption benefits

• Backup Childcare and Eldercare

• Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members

• Discount on services at Lurie Children’s facilities

• Discount purchasing program

There’s a Place for You with Us

At Lurie Children’s we embrace and celebrate diversity and equity in a serious way. We are committed to building a team with a variety of backgrounds, skills, and viewpoints — recognizing that diverse identities strengthen our workplace and the care we can provide to the Chicago community and beyond. We treat everyone fairly, appreciate differences, and make meaningful connections that foster belonging and allyship. This is a place where you can be your best, so we can give our best to the patients and families who trust us with their care.  

Lurie Children’s and its affiliates are equal employment opportunity employers.  We value diversity and are committed to creating an inclusive environment for all employees.  All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity or expression, religion, national origin, ancestry, age, disability, marital status, pregnancy, protected veteran status, order of protection status, protected genetic information, or any other characteristic protected by law.

Support email: candidatesupport@luriechildrens.org