Coding Manager
Category: Management
Facility: Genesis Medical Group
Department: GMG - Physician Coding
Schedule: Full Time
Shift: Day Shift
Hours: 80 bi-weekly / 8a-4:30p
Contact Information: Contact: Human Resources
Job Details:

JOB SUMMARY

 

Provides leadership and vision for the planning and management of GMG coding and billing, and health information management. Directly participates in and/or manages enterprise-wide projects including information management, electronic medical record, information systems, accreditation and licensure, strategic planning, and quality improvement. Serves as liaison to GMG administration, medical staff, and third parties.  Initiates and participates in quality improvement activities to improve clinical data documentation, reimbursement practices and compliance activities across Genesis Medical Group.  Serves on various committees and is a key advisor to Genesis Medical Group executive team in support of corporate objectives related to health information management, coding and reimbursement. 

 

ESSENTIAL DUTIES

1.     Oversees the operation of the clinical coding and compliance areas within GMG, including inpatient/outpatient coding, clinical data abstraction, report writing, and HIPAA compliance. 

2.     Reviews billing requirements and develops and maintains policies and procedures that support the clinical coding and compliance area, and ensures appropriate coding of services.

3.     Collaborates with the medical staff and departments to ensure the quality and consistency of clinical documentation.

4.     Coordinates audits of coding and documentation practices and initiates continuous quality improvement activities to ensure compliance with regulatory and accreditation requirements.

5.     Conducts education and training programs to keep staff and departments current on coding, reimbursement, compliance and regulatory changes and procedures.  Assesses staff educational needs and plans appropriate methods to meet development needs

6.     Continuously assesses functional work processes, initiating changes as indicated to improve efficiency and effectiveness, and moves the clinical coding functions toward industry best practices.

7.     Manages coding/billing staff including, counseling, conducting performance appraisals, interview, etc. and provides instruction to staff and management as necessary.   

8.     Monitors quality and productivity of staff including audits on staff work.

9.     Serves as a resource on HIM issues including information security, storage and retrieval, confidentiality, record retention, authorship and authentication of health record documentation, standardization of medical vocabularies, and use of classification systems.

10.   Monitors and reports key financial and operations indicators related to coding and utilizes information to improve performance. 

11.   Collaborates with other staff & departments to continually improve the flow of patient information and resolve coding and charge capture issues, compliance issues and data/information inconsistencies.

12.   Collaborates with internal and external customers to define abstract data elements; establishes policies and procedures related to data capture, retention, and retrieval; assists end users in translating data into useful information.

13.   Remains current on all coding, reimbursement, compliance, and privacy guidelines.

14.   Establishes, monitors, and continuously improves performance outcome measures, including inpatient/outpatient CMI and A/R.

15.   Utilizes automation and computer systems effectively to maintain privacy and maximize productivity, quality and customer service.

16.   Manages the implementation of ICD-10.

 

QUALIFICATIONS:

1.     Bachelor’s degree in Health Information or related field preferred. 

2.     Requires Certified Coding Specialist (CCS or CCS-P); or Certified Professional Coder (CPC).

3.     Certified Evaluation & Management Coder (CEMC) required, or obtained within one year of hire.

4.     Two years clinical coding supervisory experience required.

5.     Five years acute care coding experience required. 

6.     Trauma and critical care coding experience required.

7.     Knowledge of various reimbursement methodologies, including DRG, ASC, APC and RBRVS systems. 

8.     Demonstrated computer application skills required.  EpicCare software proficiency a plus.

9.     Strong analytic and statistical skills. 

10.   Excellent written and verbal communication skills, change management skills and the ability to manage multiple priorities simultaneously.

 

WORKING CONDITIONS/PHYSICAL REQUIREMENTS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable the individuals with disabilities to perform the essential functions.

 

1.     Able to attend sedentary meetings and planning sessions.

2.     Able to deal positively with job related stress.

3.     Able to input and review data through a computer terminal/personal computer.

4.     Able to read, write and utilize manual and computerized systems and documentation.

 

This description reflects in general terms the type and level of work performed.  It is not intended to be all-inclusive, nor portray the specific duties of any one incumbent.




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