Provider Audit and Education Manager
4 months ago
Your job is more than a job
The focus of this manager position will be on physician audit and education. This will include all medical and surgical services and specialties in a multi-hospital (and academic) setting. The incumbent will also be responsible for the successful implementation of hospital and professional based ED coding across multiple hospitals in the system. Will work closely with Population Health and have oversight of HCC/risk adjustment coding and the development of coders in this space. This is a remote position.
This position contributes to LCMC Health's financial strength, compliance and overall performance by serving in a manager capacity for Coding and Coding Compliance functions. The Manager of System Coding is a Coding Professional with a high level of clinical proficiency necessary for the oversight of the coding department and is responsible for the overall supervision, management and daily operations and delivery of coding services. This individual must have proven leadership and management skills to promote effective, efficient, and compliant assignment of charge capture, diagnosis and procedure codes which support the patient's level of care and appropriate assignment of DRG. This individual is responsible for development of action plans for improvement and must have knowledge and job experience of management and supervision of personnel.
Your Everyday
Responsible for the day to day department administrative operations. Includes 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 and others as appropriate 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 IC--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. Other duties as assigned. The Must-Haves
Minimum:
EXPERIENCE QUALIFICATIONS
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.
EDUCATION QUALIFICATIONS
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.
LICENSES AND CERTIFICATIONS
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.WORK SHIFT:
Days (United States of America)LCMC Health is a community.
Our people make health happen. While our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. Celebrating authenticity, originality, equity, inclusion and a little “come on in” attitude is the foundation of LCMC Health’s culture of everyday extraordinary
Your extras
Deliver healthcare with heart. Give people a reason to smile. Put a little love in your work. Be honest and real, but with compassion. Bring some lagniappe into everything you do. Forget one-size-fits-all, think one-of-a-kind care. See opportunities, not problems – it’s all about perspective. Cheerlead ideas, differences, and each other. Love what makes you, you - because we doYou are welcome here.
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.
The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.
Simple things make the difference.
1.To get started, take your time to fully and accurately complete the application for employment. Incomplete applications get bogged down and are often eliminated due to missing information.
2.To ensure quality care and service, we may use information on your application to verify your previous employment and background.
3.To keep our career applications up-to-date, applications are inactive after 6 months and, therefore, require a new application for employment to be completed.
4.To expedite the hiring process, proof of citizenship or immigration status will be required to verify your lawful right to work in the United States.
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