The Coding Manager is responsible for driving consistency across Independence Physician Management (IPM a subsidiary of UHS Inc.), related to medical record documentation and the correct use of CPT-4 and ICD-10 codes to ensure adherence to established Government and third party billing guidelines, AMA, AAP, CMS and coding policies. Contributes in the development of medical coding and documentation plans and materials and works with the Markets to enhance audit documents and templates to enhance the auditing and education process. Performs ongoing internal audits and presents audit findings to the Markets. Meets regularly and develops positive business relations with the Markets to provide ongoing training and education for employees and providers. Works with CBO Leadership to identify coding-related revenue cycle problems, research/analyze data to resolve issues, identify and select alternatives to address outstanding issues and implement solutions for improvement. The Coding Manager coaches, counsels and mentors the embedded (Market) Coders in an effort to develop staff and improve teamwork, morale and overall performance and results.
Responsible for driving consistency across IPM, related to clinical documentation and the correct use ofCPT-4 and ICD-10 codes to ensure adherence to established Government and third party billing guidelines, AMA, AAP, CMS and coding policies.
Performs ongoing internal audits of clinical documentation, the correct use of CPT-4 and ICD-10 codes and to ensure adherence to established Government and third party billing guidelines, AMA, AAP, CMS and coding policies.
Organizes audit samples and accurately records audit findings using company approved protocols, audit tools and worksheets.Meets regularly with Markets to discuss opportunities for improvement, impact to the revenue cycle, and ongoing training and education for providers and employees.
Maintains an expanded knowledge base of medical terminology, standard medical abbreviations, anatomy and disease processes, CPT-4 and ICD-10, and abstracting of clinical documentation to meet regulatory and compliance requirements.
Demonstrates excellent initiative and judgement. Works independently applying effective approaches to task prioritization, time management, delegation of tasks and meeting deadlines. Exhibits outstanding decision making and customer service.
Promotes a work environment of accountability and ownership. Sets appropriate standards of performance and communicates clear expectations to the Team. Shows direct and tangible evidence of coaching, mentoring and professional development.
Conducts monthly one-on-one meetings with direct reports to provide a structured time to provide coaching, discuss accomplishments and review the status of revenue cycle operations within their scope of responsibility. Discuss areas of professional development as well as goal tracking/reporting, projects and other pertinent topics. Maintains comprehensive and concise documentation of the one-on-one meetings, next steps and expectations.
Manages the employment hiring process for the Coding Integrity and Audits Department. Prepares well thought-out and meaningful performance appraisals for direct reports summarizing performance as well as focusing on opportunities for improvement and recognizing performance that exceeds expectations.
Performs other duties as assigned
Education: Associates Degree or approved equivalent combination of coursework and related experience or extensive related experience is required. Bachelor’s degree preferred.
Work experience: Experience (5-8 years minimum) working in a healthcare (professional) billing, health insurance, Coding or equivalent operations work environment. Minimum 5 years of direct supervisory experience managerial or administrative experience required. AAPC CPC Certification required.
Knowledge: Healthcare (professional) billing, knowledge of CPT/ICD-10 coding, government, government sponsored and commercial follow-up requirements as well as appeals processes and requirements. Thorough understanding of the revenue cycle and how the various components work together.
Skills: Excellent verbal/written communication skills. Strong presentation skills. Proven track record of leadership ability. Results oriented with a proven track record of accomplishing tasks and building high-performing teams. Project Management. Strong interpersonal and organization skills. Service-oriented/customer-centric. Microsoft Office. Strong computer literacy skills.
Equipment Operated: Mainframe billing software (e.g., Cerner, Epic, IDX) experience highly desirable. Microsoft skills required (i.e., Excel, Power Point).
Implantable Cardioverter Defibrillator
Medical Billing And Coding