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Clinical Director - Independence, United States - VSE
Description
Riverchase Dermatology, an AQUA Dermatology portfolio practice, is Florida's largest and most comprehensive full-service skin care provider in the Southeast, offering medical, surgical, and cosmetic dermatology, plastic surgery, vein care, and radiation oncology.
From common rashes to skin cancer treatments, and plastic surgery procedures to an array of vein treatments, no case is beyond our experience and expertise
The Coding Quality Supervisor is responsible for streamlining effective coding and documentation processes, developing, implementing, and enforcing policies and procedures, monitoring productivity and performance, and overseeing claim submission operations in a manner that is compliant with governmental and payer-specific billing requirements and regulations.
This position is highly visible and requires a strong leader with the ability to prioritize, plan, and manage the department.
ESSENTIAL FUNCTIONS
Hires, orients, supervises, and evaluates Coding Quality Auditor staff; Initiates and implements disciplinary action as needed.
Establishes productivity and KPI goals with staff; provides statistical and performance feedback on a regular basis to each team member for continuous improvement.
Maintains knowledge of current and required coding certifications as appropriate; may perform the most technically complex and difficult coding. Acts as subject matter expert for leadership.Develops and conducts education/training sessions to include best practice processes, reference materials, and tools to communicate optimal revenue cycle management and workflows.
Develops, creates, disseminates, and analyzes reports to effectively manage and continuously improve the department.Serves as a resource for providers and coders to obtain information or clarification on accurate and ethical coding and documentation standards, guidelines, and regulatory requirements.
Serves as a facility 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.
Maintains and supports evidence-based practices in coding and documentation.Monitors unbilled account reports for outstanding services or un-coded visits to reduce accounts receivable days.
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 and assures that the coding department meets the minimum productivity standards both departmentally and for individual employees.
Monitors and adheres to audit schedule including scheduled audits, re-audits, and concurrent reviews as necessary.Analyzes audit results, identifies trends, and presents audit/review findings, potential issues, and their root causes to ensure audit results are disseminated and understood.
Develops and implements templates and other tools to facilitate accurate documentation and coding. Provides provider and staff education based on audit findings. Tracks improvements to ensure adequate education and training has been provided and identified issues are corrected.Abides by the Standards of Ethical Coding as set forth by AAPC or AHIMA; Assures compliance with applicable laws and regulatory guidelines; reports areas of concern to management.
Legal aspects of medical record administration. Ability to assure compliance with applicable laws and regulatory guidelines.Effective communications with all stakeholders across the organization regarding performance, issues, and/or updates for the department.
Aides in the on-boarding of new/existing acquisitions. Helps develop processes and workflows to ensure the onboarding is successful.
Maintains the strictest confidentiality, adhering to all HIPAA guidelines.
Ensures compliance with national standards and initiatives.
Performs other related duties and works on special projects as requested by senior management.
COMPETENCIES
Proficiency in ICD-10 and CPT coding, CPC certification by either AHIMA or AAPC required. Must follow current CPT, ICD-10, Federal Register, NCCI, CPT Assistant, and payer-specific coding guidelines.
Current dermatology and multi-specialty reimbursement systems and associated regulatory review practices to include standards for medical records.
Understand and apply anatomical, physiological, and medical terminology.
Provide excellent public relations and courteous customer service; establish and maintain cooperative working relationships with others including physicians, clinical staff, administrators, managers, vendors, contractors, and other healthcare industry personnel.
Knowledge of the healthcare industry with specific knowledge of physician billing, coding, and healthcare reimbursement; proven ability to successfully manage production metrics; coding or other related processes.
Excellent administrative and management skills including the ability to motivate, delegate, control, monitor, and resolve issues in a performance-driven, complex setting.
Excellent communication skills (verbal and written), analytical, problem-solving, and decision-making skills.Ability to organize multiple priorities and/or projects by using appropriate methodologies and tools; skilled in presentations and comfortable in providing education to staff.
Must be able to work independently with little supervision.Ability to develop and implement systems for effectiveness, productivity, and technological improvement.
Proactively prioritizes needs and effectively manages resources. Must be able to meet deadlines and support others driving toward metrics and goals.
Ability to investigate and analyze information and draw conclusions
We offer competitive salaries and benefits:
Medical, Dental, and Vision available after 30 days of hire
Short-term disability and life insurance, and many ancillary options.
401k available after 90 days of hire
Excellent growth and advancement opportunities
Discounts on products and services
POSITION TYPE AND EXPECTED HOURS OF WORK
Full-Time
Monday - Friday
There is a
possibility
of working from home 2 days a week
after 90 days of employment
SUPERVISION
Supervises Coding Quality Auditors with the intent to recruit, train, assign work, manage & evaluate performance, and progressive disciplinary actions while ensuring appropriately documented in the employee's HR record.
TRAVEL
This position requires minimal travel.
Education and Experience:
High School diploma required.
CPC or equivalent
Minimum of 3 years of healthcare medical coding experience, preferably in dermatology
Knowledge of insurance claims processing, third-party reimbursement principles, and concepts.
Exceptional knowledge of CPT, ICD-9/ICD-10, HCPCS coding, billing & medical terminology
Knowledge of Medicare, OIG, HIPAA, State & Federal statutes, and regulations
Leadership/supervisory experience preferred
Proficiency in Microsoft Office Suite
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