Job Description

The Coding Team Lead – RCM serves as a mentor for their team, assisting with training and cases that have been escalated for clarification by coders. This role will frequently interact with clinicians on documentation deficiencies, as well as work with other departments.

The Coding Team Lead – RCM will support the production team as needed by abstracting medical record documentation into surgical CPT codes and crosswalking them to the appropriate ASA codes, while demonstrating a high level of competency in ICD-10 coding and coding guidelines. USAP coders abstract data into the MD Cloud Practice Solutions platform and may also utilize other charge capture systems, including Medaxion and PC7, as well as multiple facility EMRs depending on assigned location. A working knowledge of Athena IDX is required to manage edits, denials, manual tasks, and charge corrections. An understanding of coding requirements for physicians, CRNAs, CAAs, NPs, SRNAs, and residents is required. The candidate will demonstrate knowledge of NCCI bundling, LCD/NCD policies, and CMS coding guidelines. Proficiency in coding all anesthesia elements to include time, medical direction, and care team structures is required.

At this time, US Anesthesia Partners does not hire candidates residing in California, Hawaii, or Alaska.

The base pay estimate for this role is $21.97 - $35.14 hourly. The final offer will depend on the skills, experience, and qualifications of the selected candidate. This range is for base pay only and does not include bonuses or other compensation. This position is eligible for a quarterly bonus. Bonuses are not guaranteed and are awarded based on company and individual performance.

Job Highlights

ESSENTIAL DUTIES AND RESPONSIBILITIES ( The ideal candidate must be able to complete all physical requirements of the job with or without a reasonable accommodation)

• Serves as the primary source for coder inquiries.
• Reviews documentation for appropriate required elements such as attestations, signatures, dates, etc.
• Abstracts and codes surgical procedures from all sections of CPT and cross walks surgical codes to ASA.
• Applies appropriate modifiers.
• Codes ICD-10.
• Abstracts anesthesia times and events.
• Identifies and assigns care team providers.
• Reviews for medical direction.
• Meets team KPIs to include daily production and quarterly coding audit score requirements.
• Works cases that have been escalated by coding staff and provides feedback on escalated cases.
• Analyzes data and provides required reports for management as requested.
• Works complex edits and denials to include concurrency and provider time conflicts.
• Assists coders with quarterly audit findings and rebuttals.
• Collaborates on playbook development and updates (SOPs/pathways).
• Communicates complex coding questions to the coding quality and education department.
• Identifies and reports trends.
• Performs other duties as assigned.
• Adheres to all company policies and procedures, especially HIPAA and confidentiality.

Qualifications

KNOWLEDGE/SKILLS/ABILITIES (KSAs):

• High school diploma or equivalent required.
• Medical records experience required.
• Ability to self-motivate new projects.
• Ability to work independently.

*The physical demands described here are representative of those that may need to be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Occasional Standing
• Occasional Walking
• Frequent Sitting
• Frequent hand, finger movement
• Use office equipment (in office or remote)
• Communicate verbally and in writing

US Anesthesia Partners, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, gender identity, sexual orientation, pregnancy, status as a parent, national origin, age, disability (physical or mental), family medical history or genetic information, political affiliation, military service, or other non-merit based factors.