Req Number 001T3T
Job Category Finance
Supervises and coordinates the coding staff and daily operations of assigned division. Ensures compliance with government and coding regulations and standards. Functions as an objective reviewer and evaluator of coding and compliance audit issues for FPP operations.
Manages and assists in preparation and distribution of annual audit and re-audit schedules as well as workload assignments to audit team.
Oversees accuracy and release of audit charge releases to ensure timely and accurate submission of charges for revenue cycle.
Manages distribution of audit record requests to clinical departments and monitors timeliness and accuracy of submission of records by clinical departments. Reviews submissions for completeness and conformity with the request. Follows up on delinquent submissions.
Composes and distributes draft audit reports for distribution to clinical department review prior to issuance of final audit report. Reviews and responds to questions or comments from reviewers. Facilitates resolution of disputes.
Develops and maintains audit logs which include prior year results and multiple analyses based on specific criteria supplied by senior leadership. Maintains provider level detail records on annual basis.
Trends and evaluates external, including government, audit requests. Oversees development and maintenance of monthly report for Corporate Compliance and senior leadership.
Oversees revisions and updates to audit team training guide and new coder orientation manuals.
Assists with coordination of information for appeals and refunds requiring internal and external legal involvement.
Assists with data and information requests, serves as liaison between various departments to provide requested data.
Conducts reviews on centralized Coding Reimbursement Coordinators at quarterly intervals for education and quality assurance purposes. Share and discuss results with Audit, Training and CMS Initiatives Manager for presentation and monitoring.
Collaborates with management to maintain the Annual Chart Review “Executive Dashboard” for Ambulatory Services leadership.
Optimizes coding and billing practices and maintains current knowledge of billing, coding, regulatory and reimbursement related issues as they apply to multi-specialties and coordinates communication of changes to Ambulatory Services providers and staff.
Maintains current knowledge of billing, coding, regulatory and reimbursement related issues as they apply to multi-specialties and departments. Coordinates communication and education on coding process changes.
Selects, develops, manages and evaluates direct reports and oversees the selection, development, management and evaluation of indirect reports.
Evaluates staff performance at defined intervals for quality assurance.
Assigns work and sees that it is carried out correctly and efficiently for both direct and indirect reports.
Defines and monitors productivity and performance standards.
Oversees scheduling (vacation, holidays) and ensures adequate coverage. Performs related personnel and payroll functions.
*ADA Essential Functions
REQUIRED EXPERIENCE AND QUALIFICATIONS
High School Diploma or equivalent, required. Knowledge of Health Information Administration or related field, as normally acquired through the completion of a Bachelor’s Degree.
Credentials in one of the following, required:
Advanced Coding Specialist (ACS)
Certified Coding Specialist - Physician (CCS-P)
Certified Professional Coder (CPC)
Registered Health Information Administrator (RHIA)
Registered Health Information Technician (RHIT)
Minimum of five (5) years progressively responsible experience in medical records, coding and compliance, required. Prior supervisory experience in revenue cycle coding and compliance, preferred.
Excellent oral and written communication skills and ability to effectively communicate with staff and management.