Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values?integrity, patient-centered, respect, accountability, and compassion?must guide what we do, as individuals and professionals, every day.
Reporting to the Sr. Manager, Outpatient Coding, the Professional Coding Manger (Manager) is responsible for overseeing management of NEMG Professional Coding Charge Capture Analysts for all physician practices and Hospitalists. The Manager is responsible to ensure both the coding team and physicians are educated on coding and documentation practices that includes addressing coding issues and implementing controls to mitigate any potential risks. This is coupled with overseeing the work of the Supervisor and 15+ Certified Coders to ensure performance metrics are met. Duties include correct coding guidance and necessary implementation of system-wide policies, and procedures for coding, auditing and monitoring practices, education and training for coding staff and providers to ensure appropriate administration of processes for clinical accuracy, compliance, denials management and optimum reimbursement for documented services.
EEO/AA/Disability/Veteran Responsibilities 1. Provides guidance and further development of Coding Compliance functions including evaluation of existing processes, implementation of streamlined functions and development/implementation of consistent standards and practices throughout NEMG. 2. Provides oversight of NEMG Coding Supervisor to include establishment and implementation of best coding/abstracting practices, quality monitoring, coding compliance assistance, audit response practices, internal auditing program development and documentation improvement management functions. 3. Works closely with compliance and coding teams, physician management and Regional Operation Managers to carry out the strategic direction and goals and objectives for coding compliance and documentation improvement programs. 4. Participates in strategic initiatives related to the legal electronic health record and systems to support accurate and timely coding 5. Participates in the coding aspects of design, development, implementation, validation, testing and training related to Epic and related necessary edits 6. Serves as the expert in coding guidelines, regulations and coding classification systems with responsibility to educate management, physicians, and coding staff as necessary. 7. Implements coding productivity standards and workflow improvements for professional coding and charging services as needed. 8. Ensures compliance with CMS, HIPAA, OIG and other governmental and regulatory agencies by performing or overseeing coding audits by internal and external reviewers. 9. Participates in cross-functional teams for the management of projects and the implementation of strategic initiatives. 10. Develops strategy for HCC/RAF program to support alternative payment methodologies.
Bachelor's degree required.
Minimum of five (5) years of professional coding and compliance management experience. This position requires operational experience working with coders and physicians. The ideal candidate must possess experience with physician-side billing and strong supervisory experience.
Certified Coding Specialist (CCS) and/or Certified Professional Coder (CPC or CCS-P) required.
Well developed communication skills, analytical skills, and use of Microsoft Office tools. Change management skills relating to coding and compliance and skilled in information systems used throughout the coding process including implementation, change control and data reporting integrity.
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