Coding Supervisor, Inpatient and Outpatient

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Coding Supervisor, Inpatient and Outpatient

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locations

Attleboro, MA

time type

Full time

posted on

Posted 3 Days Ago

job requisition id

R5715

Under the direction of the HIM Operations Manager, the Coding Supervisor, Inpatient and Outpatient is responsible for supervising the coding functions for inpatient and outpatient coding services. This individual will be responsible for managing and working edit and denial coding queues for inpatient and outpatient services and will provide feedback for education opportunities identified to the coding team. Prepares and presents educational programs related to coding learning opportunities. Must be familiar with reviewing documentation to assign appropriate HCPCS, ICD-10-CM and ICD-10-PCS diagnosis codes. Responsibilities include writing appeal letters for DRG denials, completing retrospective queries and pre-bill coding validation for low risk MS-DRGs, APR-DRGs, and APC coding. Pre-bill reviews are conducted on 10% of all coder’s work to ensure accurate compliant coding and billing. Position includes responsibilities for drafting coding guidelines and programs to ensure ongoing education and coding consistency.

Required Qualifications and Skills: Minimum of five (5) years of coding experience in all types of facility based outpatient coding and at least three (3) years

supervisor/management

leadership experience. Working knowledge of review and resolution of NCCI, MUE, and Medical Necessity Edits edits. 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. Experience in HCPCS, ICD-10-CM/PCS, auditing, coding and reimbursement training. Knowledge of Prospective Payment System (PPS) methodology for inpatient, ambulatory, and other outpatient facility encounters. 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. Preferred Qualifications and Skills: Working knowledge of Microsoft Office Applications including Excel and Powerpoint Essential Job Functions: Completes random and focused pre-bill reviews to assure accurate sequencing, coding and abstraction. Works coding edit queues and provides feedback and coding education to coding staff regarding completeness and accuracy of code assignment. Performs coding functions to maintain consistent turnaround times for coding to billing. Works with clinical and business associates to review and provide evidence based determinations regarding the appealing, accepting and learning from denials. Ensures audit findings and trends are investigated and education is prepared and reviewed with coding staff when necessary. Prepares and distributes audit results/reports for the system coding program to Coding management staff. Monitors staff performance to ensure coding quality and quantity expectations are met. Assist system coding leadership with training and/or development of a performance improvement track for coding staff in the disciplinary process related to quality or productivity performance. Keeps abreast of new regulatory requirements, annual revisions to the codes, etc. and applies this information appropriately. Works as subject matter expert and provides expertise when applicable. Monitors changes in laws regulations, standards as they that affect coding, billing and related compliance. Identifies potential areas of compliance vulnerability and risk, develops and identifies potential corrective action plans for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future. Completes annual evaluations for all inpatient and outpatient coding staff. Other duties as assigned. Education/Training: Associate’s degree in Health Information Technology or Bachelor’s degree in Health Information Administration Certified Coding Specialist (CCS) Certified Outpatient Coder (COC) credential required. Minimum of five years (5) supervisory related experience required. Bachelor’s Degree in Health Information Administration is preferred. Licenses/Certification: Associate’s degree in Health Information Technology (RHIT) or Bachelor’s degree in Health Information Administration (RHIA) Certified Coding Specialist (CCS) or Certified Outpatient Coder (COC) credential required. Other duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. AGE AND DIVERSITY RELATED CRITERIA:

Consistently treats patients, colleagues and visitors with the dignity and respect, while being sensitive to the differing needs of all age groups, backgrounds, characteristics and cultures. ABILITY TO FULFILL JOB EXPECTATIONS:

Must have the ability to the perform essential functions of the position, including required work hours, locations and physical demands, without posing a direct threat to the health and safety of themselves or other individuals in the work place, and with or without reasonable accommodation. PHYSICAL DEMANDS:

Physical demands refer to the level and duration of physical exertion generally required to perform critical tasks in support of critical job functions, for example -

sitting, standing, walking, lifting, carrying, reaching, pushing, and pulling . Sturdy Memorial Hospital is an equal employment opportunity employer. There is no discrimination because of race, color, creed, age, gender, sexual orientation, national origin, veteran status or disability.

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