Manager Health Information Management PB Coding - Tyler, United States - Christus Health

Description

Summary:

The CHRISTUS Health Coding Manager is considered aPhysician-Based (PB) system support position that providesleadership, support, and direction, for the Director of CodingOperations and the PB coding staff. Coding Managers workcollaboratively with system Revenue Cycle, the PB Education andAudit team, the facility Health Information and Records Servicesdepartments, Patient Access Teams, Patient Financial Services,Physicians, hospital leadership and management. The Coding Manageris responsible for supporting compliance with CHRISTUS standardsand directives, the American Academy of Professional Coders (AAPC),the American Health Information Management (AHIMA), AmericanMedical Association (AMA), and Current Procedural Terminology (CPT)coding rules and guidelines, and other regulatory requirementsincluding Centers for Medicare and Medicaid Services (CMS), NCCI,Office of Inspector General (OIG), and HIPAA standards related toclinic operations. As a manager, this position ensures that Codingoperations are standardized, meet regulatory requirements, andsupport optimal department performance to support Trinity Clinicoperations and revenue cycle initiatives. This position performstimely monitoring and analysis of clinic coding operations toensure performance objectives are met to support quantity andquality standards. This position is expected to maintain effectiveprofessional relationships as appropriate to instruct, share ideas,and implement actions related to coding functions and improvements.This position monitors and reports KPIs as determined by theDirector of PB Coding Operations.

The positionhas direct oversight and accountability for the management of WQs,workload balance, staff timekeeping, staff development, mentoring,and quality assurance. The Manager has overall responsibility forall staff within the assigned unit and directly supervises thedepartment leads and staff within that unit. The Manager isresponsible for ensuring that each team member within the assignedunit is effectively, efficiently, and accurately conducting allaspects of tasks assigned. The Manager provides leadership anddirection so that productivity and quality expectations areconsistently measured and achieved, backlogs are avoided andpromotes and supports a culture of continuous learning throughoutthe department.

Responsibilities:

• Ensure records are coded accurately usingcurrent CPT, HCPCS, ICD-10-CM Guidelines, Compliance Departmentpolicy, and other corporate requirements.
• Selects, coaches, motivates, conductsperformance evaluations, and directs the workflow for staffassigned to coding function.
• Manages stafftimekeeping, PTO requests, and unscheduledabsences.
• Develops goals and performanceexpectations for staff in targeted areas, such as unbilled accountsreceivable, quality and timeliness of clinical coding assignments,data integrity and reimbursement with third party payers.
• Provides for the education, development, andshared leadership of staff.
• Assists in settingand maintaining budgetary department goals for the coding area.Monitors overtime to help achieve budgetgoals.
• Participate in organization performanceimprovements by creating and monitoring the coding scorecard whichincludes coding productivity; coding accuracy; WQ backlog, etc.
• Monitors goals, productivity, and qualitystandards in conjunction with industry trends and CTC needs.
• Participates in developing standard codingpolicies/procedures/guidelines to ensure compliance with federal,state. and local regulatory guidelines to minimize risk for theorganization.
• Supports coding infrastructureto ensure regulatory compliance in all aspects of coding andabstracting of clinical data to support patient careprocesses.
• Set expectations and allocate workutilizing KPIs to drive productivity and efficiency.
• Provide technical support to medical providersand coding/billing specialists as appropriate regarding codingcompliance documentation, regulatory provisions, and third-partypayer requirements.
• Research root causes andinitiate claims resolution in the billing system with knowledge ofthe upstream and downstream impact of work.
• Leverage functionality of Epic to increase clean claim rate, reducedenial rates and increase cash collections, through implementationof claim rules and edits.
• Directly communicatewith physicians and practice managers on areas ofopportunity.
• Monitor WQs to maintain grasp oncoding backlogs, and proactively shift coders to areas needingadditional support.
• Counsel employees inperformance improvement, conflict resolution, disciplinary action,and coordination of employee schedules for adequatecoverage.
• Works with departmental appealsstaff to identify trends and developsolutions.
• Works in conjunction with the PBEducation Department and Compliance to ensure that educationalprograms are appropriately developed anddelivered.
• Assists with evaluation of newclinics and services by researching appropriate coding/billing andpayer coverage policies as well as staffingneeds.
• Holds regularly scheduled staffmeetings and makes minutes available to staff andDirector.
• Maintains effective communicationwith physician offices to ensure smooth and efficient departmentoperations, advising director as necessary to expedite resolutionof any problems.
• Assumes responsibility forpersonal and professional development to ensure current knowledgein the profession/position.
• Supervise externalvendors who provide coding services to ensure accuracy andcompliance.
• Ensure coding staff maintains ahigh quality and productivity standard, per department benchmarks.
• Disseminates changes in coding rules such ascorrect coding initiative (NCCI), AMA, CPT Assistant and CodingClinic.
• Monitor changes in laws, regulations,and policies that impact clinical documentation, reimbursement, andcoding to assure compliance.
• Promote morale byeffectively communicating goals, standards and needs of thedepartment and organization.
• Foster anenvironment of teamwork and service excellence within thedepartment.
• Provide leadership for processimprovement and redesign to improve customer satisfaction, reducecosts, and/or meet departmental and institutional goals andobjectives.
• Work and communicate with alldepartments, coding professionals, and medical staff to improvedocumentation in the medical record.
• Facilitate cross training opportunities for coders.
• Interview, assess and hire new codingassociates.
• Ensure compliance with the OIG,CMS, commercial payer policies, and plays a key role in denialsmanagement involving coding relatedissues.
• Perform other duties asassigned.

Requirements:

• Bachelor's degree, medical record science ormedical record administration preferred, or equivalent physicianpractice leadership experience required.
• Subject matter expert in Evaluation andManagement, CPT coding guidelines and required documentation.Strong knowledge in ICD-10 CM, CMS/NCCI, Modifiers and HCCcoding.
• Extensive knowledge of NCDs / LCDs andhow to successfully navigate updates to decrease impact to claimprocesses.
• Strong working knowledge of payerdenials and policies.
• Strong knowledge ofpayer and clearinghouse claim edits and rules.
• Strong presentation skills, with ability to effectively communicateto Executive and Physician leadership teams on KPIs and strategicpriorities.
• Excellent relationship buildingskills and aptitude for working collaboratively withcross-functional groups.
• Able to independentlymanage multiple tasks and deadlines, with minimaloversight.
• Able to clearly document processesand facilitate process to external users.
• Demonstrated attention to detail required.
• Critical thinker with ability to problem solve, perform root-causeanalysis, and implement action plans.
• Mustpossess a strong working knowledge in internal integrityrequirements and procedures.
• Knowledge ofgovernmental, federal, state, and local regulations related tobilling rules and compliance.
• Must possessstrong analytical skills.
• Excellent oral andwritten communication skills required.
• Musthave strong knowledge of common office software applicationsincluding Power Point, Excel, Word, etc.
• Minimum of five (5) years' experience in a physician-based codingdepartment of a large group or a mid-large healthcare system,including two (2) years in either a Coding Lead or Coding Managercapacity
• Experience with remote work forceoperationsrequired
• CertifiedProfessional Coder (CPC),preferred
• Certified Coding Specialist – Physician-based(CCS-P), preferred
• Registered HealthInformation Administrator (RHIA)

Work Type:

Full Time

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