Coding Manager - Professional Billing

Location: Minneapolis, MN
Date Posted: 10-27-2017
CODING MANAGER – PROFESSIONAL BILLING
 
SUMMARY
Responsible for the management and strategic direction of the professional fee coding area to ensure coding accuracy, timeliness and maximum equitable reimbursement from all carriers. Professional fee coding should be completed and processed within the time frames established by revenue cycle management as well as backlogs and rejections are minimized. Oversight will be required in the following functions: medical record documentation, archiving, coding accuracy audits, and reporting. Other Management responsibilities include: strategic planning, budget preparation and oversight; hiring, disciplining, and terminating employees; staff development to ensure that this area meets the service needs of the organization. Serves as a resource and assists with organizational compliance on HIPAA Privacy standards, release of information standards and The Joint Commission standards. Ensures appropriate procedures and policies are created and revised as needed and provides direction to the organization regarding the implementation of these policies. Works collaboratively as a key participant in the development and implementation of Epic and Optum system enhancements to ensure efficient and effective processes and workflows in the professional coding area.
RESPONSIBILITIES
  • Responsible for the management and strategic direction of the professional fee coding department, which includes, medical record documentation, archiving, chart audits, and reporting. This position has shared responsibility to achieve the business unit goals in targeted areas such as unbilled accounts receivable, compliance with regulatory requirements, coding and data accuracy and reimbursement from third party payors. Management responsibilities include: strategic planning, budget preparation and oversight; hiring, disciplining, and terminating employees; staff development to ensure this department meets the service needs of the organization as follows:
  • Interview, hire, orient, review and discipline employees
  • Conduct employee performance evaluations and reviews, annual salary review, and performance documentation and discussion
  • Coordinate and prioritize work flow
  • Oversee the scheduled work hours; monitor staffing, time cards, overtime, vacations, and time off
  • Conduct appropriate departmental staff meetings
  • Ensure new employee training is completed and training for all employees is current and ongoing
  • Assist employees in solving problems as necessary
  • Monitor and recommend staffing levels
  • Monitor accuracy, efficiency and productivity of all coding personnel to ensure compliance with departmental performance standards
  • Develop and maintain budget for the professional fee coding department Works with staff to ensure compliance of, and proper coding procedures are adhered to as defined by CMS regulations, Local Medicare Carrier Review Policies (LMRP), Local Carrier Determinations (LCD), the AMA any applicable compliance policies, as well as any relevant accrediting and payer organizations
  • Works with staff to ensure compliance of, and proper coding procedures are adhered to as defined by CMS regulations, Local Medicare Carrier Review Policies (LMRP), Local Carrier Determinations (LCD), the AMA any applicable compliance policies, as well as any relevant accrediting and payer organizations
  • Serves as a resource and assists with organizational compliance on coding policy and practices, HIPAA Privacy and interrelated Security standards, release of information standards and The Joint Commission standards that apply to the professional coding functions
  • Ensures that coding and operational policies are created and revised as needed and provides direction to the organization regarding the implementation of these policies
  • Works collaboratively as a key participant in the development and implementation of system enhancements and modifications of coding workflows
  • Facilitate the collection of information to provide ongoing feedback to physician on work performance to ensure accuracy and consistency with all professional coding
  • Attends management meetings, interacts with management to resolve problems and acts as a liaison to the revenue cycle management team
  • Assists Revenue Cycle Management with the development and implementation of administrative policies, procedures and guidelines for departmental operations; Responsible for periodic evaluation of operational processes to assess relevancy to changing goals and objectives of the department
  • Maintains mutual respect and ensures mutual understanding with all personnel
  • Proactively identifies and evaluates issues and identifies appropriate subject matter experts and other information resources to resolve problems
  • Builds a cohesive team by establishing clear direction, goals and responsibilities; Supports the team’s success by providing necessary resources and breaking down barriers; Creates an environment which fosters motivation and builds commitment
REQUIREMENTS
  • Bachelor degree in business and /or healthcare administration, Health Information Management or Health Information Technology
  • Certified Professional Coder (CPC) certification or Certified Coding Specialist-Physician (CCS-P), Registered Health Information Administrator (RHIA) Registered Health Information Technologist (RHIT) in an active status with the American Health Information Association (AHIMA) preferred
  • Five (5) years Healthcare management experience with supervisory/management responsibilities OR an approved equivalent combination of training and experience
Knowledge / Skills / Abilities
  • Epic Physician Billing Coding functionality
  • Optum Claims Manager and Encoder
  • Knowledge of state and federal legislation for HIPAA Privacy, medical record access and release of information, and regulatory and accreditation agencies; retention of medical records; storage and retrieval systems, Knowledge of current medical record technology, statistics, data presentation and reporting; Skilled in the use of computer systems, including practice management systems, reporting tools and the Microsoft office suite; creating presentations, facilitation of meetings
  • Develop and implement policies and procedures
  • Leadership Knowledge / Skills / Abilities
  • Ability to effectively manage company resources (i.e. budget and personnel)
  • Skilled in overseeing the efforts of high-level department individuals
  • Superb ability to motivate employees and inspire positive change within department
  • Innovative thinker; Ability to contribute new ideas that support organizational goals
  • Skilled in managerial duties (i.e. hiring, firing, performance appraisals, pay reviews)
  • Skilled in modeling company values through daily interactions within the department, particularly with regards to health and safety
  • Capable of supporting the work of the department
  • High standard of ethics, discipline, and professionalism
  • Skilled in fostering a positive workplace culture and building inclusive workplace teams
Preferred Qualifications
  • Certificate of registration as a registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) preferred
 
 
The Informatics Group is a Healthcare IT company which provides clinical experts to healthcare organizations who are implementing clinical applications.
 
All qualified candidates will be contacted within 48 business hours for initial phone interview and to discuss these opportunities further.
 
Send your resume to jobs@theinformaticsgroup.com
 
For more information, visit: <http://www.theinformaticsgroup.com>
 
 
 
 
 
 
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