Medical Coding Manager
Company: Lake County IL
Posted on: June 21, 2022
General Description As the largest human service provider in
Lake County, we believe that services must be available without
barriers. No residents are turned away due to the inability to pay.
We believe in providing services in an environment of mutual
respect, free of discrimination or bias. Whether assuring
accessible and effective care, impacting policy, or assessing and
monitoring risks, the Lake County Health Department and Community
Health Center has been an essential part of the public health
system in Lake County for 60 years. We are looking for passionate,
qualified team members, who can help make a difference in our
agency, and most importantly, in our community. Summary This
position will oversee the daily operations of medical, dental,
behavioral and chemical dependency coding team. This role is
responsible for the management and supervision of the Medical
Coding Specialists, development and maintenance of a comprehensive
coding education program as well as coordinating Quality Assurance
Reviews and compliance audits. The role conducts independent and
collaborative audits according to the compliance work plan and
develops appropriate documentation to support audit work performed.
Provides feedback from audit results for documentation and coding
quality improvement. In addition, this role is responsible for
developing an educational pathway for Providers, and Medical Coding
Specialists. This role will work closely with the Revenue Cycle
Manager to drive in "front end" workflows and business processes.
Also, works closely with EMR specialists to ensure standardization
and workflow consistency/compliance. Performs work of considerable
difficulty and works in a highly independent role. Scheduled Hours:
40 hours a week * Monday-Friday (8:00am-5:00pm) Essential Functions
* Supervises Coding Group of medical and coding personnel including
hiring, onboarding, ongoing training, ensuring active credentials,
and performance management as well as improves workflow and
productivity of the coding team.
* Acquires and utilizes knowledge of the LCHD/CHC NextGen system in
order to accurately and effectively coordinate requirements between
the LCHD providers, Central Billing Office and the funding
* Lead or participate in cross-functional workgroups/committees as
needed to represent coding issues.
* Assists with the onboarding and ongoing training of new
physicians and other staff, in regard to coding, billing staff for
claim resolution and coding staff, following established processes
and collaborating with the appropriate functions to ensure
* Assists in policy and procedure creation, updates, and
* Effectively utilize ICD, CPT/HCPCS and related materials to
investigate coding issues and produce accurate results
* Works collaboratively with medical, nursing, ancillary, and
coding team to improve the quality of chart documentation,
identifying any need to clarify documentation in the medical
record, which includes direct communication with clinical
* Understand Medicare billing rules (i.e. LCD/NCD, CCI, Medical
Necessity, and ABN) and communicate this information to staff, and
* Assist with any system template changes needed to support medical
coding and billing requirements determined by Medicaid, Medicare,
Managed Care, private insurance, state payers like Department of
Mental Health, Family Planning and other third party payers
* Monitor regulations for updates and changes, providing education
* Analyzes HEDIS provider data, develops recommendations for
provider education, patient outreach efforts to support HEDIS
* Uses the NextGen patient management system, electronic health
records, crystal reports, and personal computer spreadsheets to
* Coordinates external audits, report findings and implement
* Monitor services performed to ensure all encounters are captured,
coded and billed within timeframes
* Work with the Revenue Cycle Manager to resolve payer denials and
implement processes to ensure accurate reimbursement
* Conduct system testing, provide feedback, and support
conversions/implementations on coding
* Develops and performs audits to help determine and validate
documentation and coding issues and gaps; analyzes audit results
and identifies patterns, trends and variations in coding and
documentation practices; and makes recommendations for
* Performs coding functions as needed to maintain coding skills and
maintain a comprehensive understanding of the coding workflows.
* Actively participates in meetings and/or seminars and
disseminates the information to peers to enhance the knowledge and
skills of the department. Knowledge Skills Abilities and Education
Required * Bachelor's degree and five (5) years of progressively
complex coding work experience and training delivery OR
* Associate's degree and eight (8) years of progressively complex
coding work experience and training delivery with a large and
diverse FQHC medical, dental and behavioral health outpatient
* Five (5) years of supervisory experience.
* Expert outpatient coding knowledge, including in-depth
understanding of coding guidelines, conventions, CPT, and
Evaluation and Management classification systems and knowing how to
utilize resources available.
* Experience with the electronic health record and health care
applications required. NextGen experience preferred.
* Certified Coding Specialist (CCS or CCS-P) or RHIT, through the
American Health Information Management Association (AHIMA) or
Certified Professional Coder (CPC) through the American Academy of
Professional Coders (AAPC) is required.
* High level of competency with Microsoft Office tools.
* Advanced knowledge of disease processes, ICD-10, CPT and HCPCS
coding applications, clinician documentation of government
regulations and areas of scrutiny for potential fraud and
* Ability to review analyze and interpret billing guidelines and
state and federal regulations.
* Ability to create training material and presentations.
Supplemental Information You can find additional information about
the Lake County Health Department, our culture, and why you should
join our team at As a public health department, we believe in the
science, data, and power of vaccines, like the influenza and
COVID-19 vaccines, to protect against and prevent illness.
Therefore, we require all Health Department staff to receive the
primary series of the COVID-19 vaccine as well as the annual
influenza vaccine unless they have an approved medical or religious
exemption. Any offer of employment is conditioned on the successful
completion of a background screening, drug and alcohol testing and
may include a pre-employment medical exam. The Lake County Health
Department and Community Health Center is an Equal Opportunity
Employer. We evaluate qualified applicants without regard to race,
color, religion, sexual orientation, gender identity or gender
expression, national origin, disability, veteran status, and other
Keywords: Lake County IL, Waukegan , Medical Coding Manager, Executive , Waukegan, Illinois
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