United States onlyAbout Us:
Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.
We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.
JOB SUMMARY:
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.
Position Summary
The Health Information Management Coding Manager provides day-to-day oversight, direction and management for the
hospital inpatient and hospital outpatient coding functions .
The Coding Manager ensures the quality, accuracy and timeliness of all the coding completed within Health Information Management. The position is responsible for planning, analyzing and development of operations, procedures and processes with respect to coding.
Position also acts as a liaison and consultant for other departments with respect to coding and coding regulatory requirements. The coding manager is responsible for yearly cost center budgeting and advises the HIM Director in the area of coding, coding education, coding
software, coding staffing and budgeting.
The coding manager is responsible to ensure appropriate staffing for all areas coded by Health Information Management.
Specialized Knowledge and Skill Requirements
Strong background in CPT, HCPCS and ICD coding along with any relevant regulatory requirements for coding.
Demonstrated excellent written and verbal communication skills. Working knowledge of healthcare payment systems.
Ability to work with physicians and staff at all levels. Ability to function as an educator and advisor to physicians and staff.
Working knowledge of computer software programs such as Microsoft office, Computer Assisted Software and Encoders.
Working knowledge of state and federal requirements for healthcare billing. Critical thinking and organizational skills required. Requires the ability to plan and schedule to meet deadlines.
Essential Functions
Communicates effectively with internal and external customers to identify and resolve issues regarding billing, reimbursement, coding, audits or case mix index.
Conducts regular audits and ongoing monitoring of coding accuracy and provides feedback and focused educational programs on the results of auditing and monitoring activities to affected physicians and organizational staff.
Reports coding quality and accuracy regularly according to HIM policy.
Supervises and manages all inpatient and outpatient coding activities and staff
Directly assists and mentors all clinical staff, administration, department managers and compliance staff regarding information or clarification of accurate and ethical coding standards, guidelines and regulatory requirements.
Ensures the appropriate dissemination of regulatory or compliance guidelines and changes related to coding.
Ensures proper coordination between Concurrent Clinical Documentation Specialists, inpatient coders, outpatient coders, physician advisors, vendors that provide coding services, physicians, nurses, and other ancillary staff toidentify and record principal and secondary diagnoses, principle and secondary procedures, and assignment of the working DRG.
Manages HIM physician advisors to ensure flow of queries and chart reviews.
Utilizes appropriate tools to track productivity, quality and timeliness of coding programs, interprets findings and reports them to Health Information Management Director and hospital administration.
Hires and trains coding staff to ensures coding team provides timely, accurate and high quality coding while optimizing revenue and maintaining compliance through varied venues and tasks (auditing, education and training).
Serves as the point person for questions regarding coding. Attends meetings regarding this area as needed.
Maintains internal controls and management reports to monitor accounts receivables, productivity and quality. Maintains AR days under 5.
Reviews and follows up on all PRO/Insurance review correspondence related to medical record documentation and coding.
Reviews all DRG changes/denials and prepares letters of correspondence/appeal when needed.
Works with RAC coordinator on all government audits and reviews. In conjunction with the compliance team reviews and provides input and follow up asneeded for any payer specific coding audits and reviews.
Maintains active involvement in all regulatory compliance functions by maintaining up to date working knowledge of latest healthcare trends in coding, reimbursement and clinical care management.
Works with the EMR team to ensure record compliance with State and Federal Laws.
Responsible for preparing and managing budgets for inpatient and outpatient coding areas.
Must hold current credential with AAPC or AHIMA. 5 years Coding experience preferred. 3 years supervisory or management experience preferred.
PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
