Healthcare Manager for Coding and Compliance

4 weeks ago

New Orleans, Louisiana, United States LCMC Health Corporate Full time

Job Summary:

LCMC Health Corporate is seeking a skilled Coding and Compliance Manager to oversee the coding department and ensure accurate and compliant assignment of charge capture, diagnosis, and procedure codes. The ideal candidate will have a strong background in healthcare management, coding, and compliance, with experience in managing coding teams and implementing coding standards.

Key Responsibilities:

  • Manage the coding department, including planning, directing, and controlling employee workload and schedules.
  • Oversight of coding functions associated with billing and coding.
  • Provides ongoing instruction and information for coding staff on ICD-CM, ICD-PCS, CPT/HCPCS, MS-DRGs, APR-DRGs, and E/M assignment.
  • Manages and works edits and denial work queues.
  • Monitor and manage coding workflow, work queues for DNFB and charge capture to ensure accounts are coded and processed in a timely manner.
  • Implements and monitors adherence to standardized workflows, productivity, and quality standards for LCMC coding.
  • Plan and implements new procedures, maintains appropriate staffing levels, makes budgetary recommendations, and leads coding-related projects.
  • Provides analysis to monitor correct coding by the coding staff, and monitor coding-related denials to identify trends and maximize facility reimbursement.
  • Responds to external and internal audits for government and private payers.
  • Accountable for attainment of goals and revenue cycle key performance indicators.
  • Maintains communication with Director and AVP on backlogs and keeps abreast of necessary situations and circumstances that arise in the department as it relates to employees, patients, physicians, and any other customer.
  • Maintains working knowledge of ICD-CM, ICD-PCS, CPT/HCPS, MS-DRs, and APR DRG coding principles, governmental regulations, protocols, and third-party payor requirements pertaining to billing and documentation.
  • Reviews and approves personnel matters pertaining to interviews, hires, evaluations, counseling, training, and makes recommendations for termination for staff as appropriate. Review provisions for staff development, training, and orientations as prescribed by LCMC and departmental standards.
  • Collaborates with other system leaders (Revenue Integrity, Case Management, Central Business Office, Patient Access, Medical Staff, etc.) to establish accountability and coordination between Coding and LCMC Health's other clinical and administrative departments.

Requirements:

  • 5 years of hands-on experience in coding with a HS Diploma, which must include 2 years of acute care or physician coding leadership experience (including supervisor, coordinator, team lead, etc. role).
  • 2 years of acute care or physician coding leadership experience (including supervisor, coordinator, team lead, etc. role) with an Associate's degree.
  • Required: HS Diploma
  • Preferred: Bachelor's or Associate's degree in health information management, medical records administration, health services administration, or health sciences, or other related field.
  • RHIT, RHIA, or CCS or Internal staff who are not certified must obtain medical coding certification.

Skills and Abilities:

  • Knowledge as it relates to, but not limited to, electronic health record, health information systems, and healthcare applications and their effects on Coding practices today and in the future.
  • High ethical standards.
  • Knowledge of ICD-CM, ICD-PCS, CPT/HCPS, MS-DRG, APR-DRG, and APC coding guidelines.
  • Extensive knowledge of hospital and professional coding including provider-based billing.
  • Experience with concurrent coding reviews.
  • Knowledge of medical terminology, classifications systems, and vocabularies.
  • Knowledge of privacy and security regulations, confidentiality, laws, access, and release of information practices.
  • Experience in assisting and identifying learning needs as well as providing education and training designed to support a learning organization.
  • Strong analytical abilities and problem-solving skills.
  • Excellent oral, written, and interpersonal communication skills.
  • Ability to organize and set priorities to ensure objectives are met in a timely manner.
  • Ability to adapt to change and handle challenges proactively and with pose.
  • Ability to effectively collaborate with physicians and managerial staff at all levels.

LCMC Health is an Equal Opportunity Employer:

LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.

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