Coder Lead Facility - Day Surgery/Observation
Apply for the Coder Lead Facility - Day Surgery/Observation role at Aurora Health Care .
Base Pay Range
$30.15/hr - $45.25/hr
Major Responsibilities
Acts as a resource and role model to team members, providing training, day-to-day direction, performance input, monitoring progress, quality, accuracy, productivity, staffing, and guidance on complex issues.
Codes routine to complex procedures and diagnoses using ICD, CPT, and HCPCS guidelines for government and commercial payers, meeting or exceeding department quality and production standards.
Performs informal quality reviews monthly and provides coding education for accuracy; may assist with provider education regarding policy requirements of federal and state agencies.
Abstracts documentation to select correct ICD, CPT, HCPCS codes; detects, reports, and resolves billing compliance issues; serves as liaison between business office, records, patient care, and coding department.
Processes denial management claims and addresses patient concerns; provides pre-authorization referrals and charge estimates; coordinates payer audit reviews and coding-related audits.
Participates in departmental projects such as research, claim scrubbing, quality checks, presentations; acts as system/application administrator and troubleshoots issues.
Suggests policy modifications to align with insurer requirements; serves as subject matter expert and participates in coding meetings.
Adheres to organizational and internal policies; follows query guidelines and coding standards; obtains clarification of inaccurate documentation.
Reviews complex documentation and assigns diagnosis and procedure codes using ICD-10 CM/PCS, CPT, HCPCS, ensuring compliance with federal and insurer regulations via EMR/ACR software.
Practices ethical coding per AHIMA standards, maintains confidentiality of patient records, and reports non-compliant practices.
Meets departmental quality (≥95%) and productivity (≥100%) standards; supports discharged-not-final-billed reporting; assists in annual edit review.
Performs any other assigned duties; maintains correspondence at all levels; mission may change duties at any time.
Licensure, Registration, and/or Certification Required
Coding certification from AAPC or AHIMA.
Education Required
Advanced training beyond high school including completion of an accredited medical coding specialist program or equivalent experience.
Experience Required
Typically 7 years of professional coding experience, including revenue cycle processes, health information workflows, or related healthcare leadership experience.
Knowledge, Skills & Abilities Required
Maintain continuing education through webinars, updated guidelines, and coding clinics.
Advanced proficiency of ICD, CPT, HCPCS coding guidelines; extensive medical terminology, anatomy, and physiology knowledge.
Excellent computer skills with Microsoft Office and electronic coding systems.
Strong communication, interpersonal, organizational, prioritization, analytical, and reading comprehension skills.
Ability to work independently, exercise judgment, meet deadlines in a fast-paced environment, take initiative, and collaborate with others.
Physical Requirements and Working Conditions
Exposed to a normal office environment.
Must be able to sit for extended periods.
Must maintain continuous concentration.
May be required to travel to other sites; exposure to road and weather hazards.
Operates all necessary equipment.
This job description indicates the general nature and level of work expected of the incumbent; it is not intended as a comprehensive listing of duties.
This job description is generalized and may not cover all duties.
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