The position ensures coding accuracy and revenue integrity for appropriate reimbursement. This role includes the leadership of all coding staff, education, and auditing of their performance and productivity. The manager will provide hands on support, represent the department at meetings and provide physician education in interpretation, coding compliance and documentation improvement. Functions as a coach and mentor to the coding specialists.
Key Result Areas:
· Oversees department’s work queues and productivity reports to ensure timely submission of charges.
· Develops and implements standardized physician-based coding guidelines and documentation requirements.
· Provides education and guidance on professional coding policies, guidelines and procedures to maximize revenue opportunities while minimizing compliance risk.
· Reconciles changes and analyzes productivity and reimbursement reports to identify trends and improve revenue opportunities.
· Manage, identify, research, resolve and report any issues involving daily workflow and quality of work.
· Works with revenue cycle management to ensure compliance guidelines are established consistently throughout organization.
· Keeps abreast of new technology in coding and abstracting software and other forms of automation and stays informed about transaction code sets, HIPAA requirements and other potential issues impacting coding functions.
· Participates in and/or supports the Orientation of newly hired staff members.
· Provide leadership, training and review coding to evaluate performance of Coding Specialists.
· Maintains both internal and external customer and client relationships as required and manages expectations related to the performance of deliverables and non-standard issue resolution.
· Maintain compliance with Federal and State regulations
· Budget Management for department
· Process improvement for department
Hospital billing specialists, ESRD specialists, Chart Reviewers, Vascular billers, Billing assists
Education and Experience:
· Bachelor’s degree in Business, Finance or Health Administration field is preferred
· CPC in good standing with AAPC
· 5 years progressive professional coding experience with extensive knowledge of ICD-10 and CPT codes assignment, principles and guidelines, reimbursement systems, and federal, state and payer-specific regulations and policies relating to documentation, coding and billing
· 2 years supervisory experience
· Strong knowledge of medical billing practices
· Working knowledge of anatomy and procedural terminology
· Understanding of HIPAA laws and regulations
· Computer proficiency, (MS Office – Word, Excel, Power Point)
· Expert knowledge of coding, billing and third-party reimbursement
· Ability to manage multiple projects
· Strong prioritization, analytical and critical thinking skills
· Strong organizational and leadership skills, responsible for the work outcomes and results of their staff
· Demonstrated strong communication (both orally and written), problem-solving, analytical and time management skills
· Fosters an environment that promotes responsibility, transparency, and cooperation
· Keeps information confidential and complying with all HIPAA standards
· Ability to integrate industry best practices into current operations
· Ability to coach, mentor and teach staff and leaders to integrate process and performance improvements
· Intermediate level proficiency with Excel, Access and PowerPoint
· PM Software, Athena experience preferred
· pMD experience preferred
Required Certificates, Licenses and Registrations:
CPC through AAPC or RHIA
Working conditions are of a normal office environment, including fluorescent lighting, computer work, and other normal office conditions. While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; sit; walk; use hands to finger, handle or feel; and reach with hands and arms. This position requires the ability to occasionally lift office products and supplies, up to 20 pounds.
This is a full-time position, 40 or more hours of work and days are Monday through Friday, some evenings and weekends maybe required.
This job description is intended to describe the general nature and level of work being performed by people assigned to this position. It is not intended to be an exhaustive list of all responsibilities, activities and skills required of the position and people in the position.
Job Type: Full-time
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