Millennium Physician Group
  • 30-Aug-2018 to 29-Oct-2019 (EST)
  • North Fort Myers, FL, USA
  • Salary
  • Full Time

Coding Manager Summary Description:

This position reports to the Director of Revenue Cycle.  The coding manager is an AAPC Certified Professional Coder responsible for supervising the coding staff that deals with patients' medical records. The Manager is responsible for the daily oversight of the coding team activities including but not limited to reviews of coding accuracy and documentation, educational programs for healthcare providers and staff, and guidance and advice for policies as required by both government and commercial carriers with respect to coding data which includes ICD-10 and CPT assignments.  The coding manager is also responsible for the analysis of data with respect to coding trends at both individual healthcare provider and organizational levels and communicates these findings as well as facilitates improvement efforts when identified.  The coding manager is also an integral part of the Millennium's internal compliance program coordinating with the Compliance Officer as necessary. 

Essential Duties and Responsibilities include the following. Other duties may be assigned.

 

  • Supervises and performs a wide range of activities pertaining to the review and coding/billing of inpatient and outpatient medical record information for Millennium's healthcare providers and patients.
  • Establishes, implements and maintains a formalized review process for coding compliance, including a formal review (audit) process; designs and uses audit tools to monitor the accuracy of clinical coding/billing.
  • Oversees the performance of data quality reviews on inpatient records to validate the International Classification of Diseases Manual (ICD-10-CM), and other codes; checks for missed secondary diagnoses and procedures and ensures compliance with all reporting requirements; monitors Medicare and other carrier bulletins and manuals.
  • Cooperates with the Compliance Officer to perform reviews of the current Office of the Inspector General (OIG) work plans of identified potential risk areas.
  • Performs data quality reviews on inpatient and outpatient encounters to validate the ICD-10-CM, the Current Procedural Terminology (CPT), and the Healthcare Common Procedure Coding System (HCPCS) Level II code and modifier assignments; verifies Ambulatory Payment Classification (APC) group appropriateness; checks for missed secondary diagnoses and/or procedures; ensures compliance with all APC mandates and outpatient reporting requirements; monitors medical visit code selection against facility specific criteria for appropriateness; assists in the development of such criteria as needed.
  • Performs follow-through reviews that billing accurately reflects accurate coding documentation.
  • Creates and monitors reports pertaining to code utilization to identify patterns, trends and variations in the organizations frequently assigned levels of service; investigates and evaluates potential causes for changes or problems; takes appropriate steps in collaboration with the right staff to effect resolution or explain variances.
  • Oversees the continuous evaluations of the quality of clinical documentation to identify incomplete or inconsistent documents for inpatient and/or outpatient encounters that impact the code selection and resulting APC/DRG groups and payment; brings concerns to the attention of the Director of Revenue.
  • Provides or arranges for training of healthcare professionals in the use of technical coding guidelines and practices, proper documentation techniques, medical terminology and disease as they relate to the DRG, APC and other data quality management.
  • Maintains knowledge of current and required coding certifications as appropriate; may perform the most technical complex and difficult coding and abstraction work.
  • Selects, assigns, and trains subordinate coding and clerical staff; directs, monitors and evaluates work; reviews and makes decisions regarding leave requests; initiates and implements disciplinary action as needed; assists with and promotes the recruitment and retention of qualified staff as assigned.
  • Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association; reports areas of concern to the Compliance Officer
  • Assists the Director by serving as a department representative by attending coding and reimbursement workshops and bringing back information as appropriate; communicates any updates published in third-party payer newsletters, bulletins and/or provider manuals; shares information with facility staff as directed.
  • Stays informed about transaction code sets, Health Insurance Portability and Accountability Act (HIPAA) requirements and other future issues impacting health information management functions; keeps abreast of new technology in coding and abstracting software and other forms of automation.
  • Demonstrates and maintains competency in the use of computer applications.
  • Monitors unbilled account reports, hold lists etc.; for claims awaiting coder review and facilitates the delegation of work in an effort to reduce accounts receivable days for these claims.
  • In partnership with appropriate personnel, recommends and implements standardized, organization-wide coding guidelines and documentation requirements; develops and implements training and educational programs for physicians, staff and coders.
  • Facilitating/overseeing Medical Records request from 3rd Ensuring timely delivery of secure patient information, i.e. CERT/ADR records
  • Project management of multiple initiatives with ability to prioritize and meet deadlines.
  • Clear, concise and professional communication to varying audiences dependent on the project and its goals.
  • Time management, meetings, travel and deadlines may require hours outside standard 40 hour work week.

 Supervisory Responsibilities

Directly supervises ten or more employees in the Coding department. carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

Education and/or Experience

A Bachelors degree is preferred but not required.  A minimum of 4 years related physician coding/billing experience and/or training; or equivalent combination of education and experience. Position requires flexibility in work hours, multi-tasking, and excellent computer skills.

Must be AAPC CPC certified!

CPMA, CPPM, CDEO or CPCO a plus!

Millennium Physician Group
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