Establishes and maintains an efficient and timely coding process while ensuring the accuracy and quality of coded and abstracted information for all patient types across all hospital campuses, physician services, and remote facilities of the Children's Healthcare of Atlanta system. Provides ongoing education to coders, physicians, and other clinical staff. Serves in a management and advisory capacity to the Coding staff and in an educational and advisory capacity to the clinical staff and physicians as it relates to documentation, coding, and regulatory compliance. Works effectively with the Director, HIS & Coding to increase and improve coding services.
- Bachelor’s degree in Health Information Management/Health Information Technology or 10 years of managerial experience in Health Information Management
- Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician(CCS-P), or Certified Professional Coder (CPC)
- 5 years of experience in coding management in a physician practice/clinic setting.
- 5 years of experience in facility coding in an acute care setting
KNOWLEDGE SKILLS & ABILITIES*
- Proven knowledge base in complete and accurate clinical documentation in all healthcare settings and for all healthcare disciplines
- Demonstrated knowledge base and experience in acute care hospital and physician/clinic coding and billing practices
- Demonstrated knowledge of the conventions, rules, and guidelines for multiple classification systems, including ICD-10 diagnosis and procedures, CPT and Evaluation & Management coding systems
- Knowledge of multiple reimbursement systems (e.g., Medicare Severity-Diagnosis Related Groups (MS-DRG) and Ambulatory Payment Classification (APC)
- Knowledge of clinical documentation improvement methodologies
- Ability to accurately interpret and implement regulatory standards, including the National Correct Coding Initiative (NCCI) and Medically Unlikely Event (MUE) policies.
- Ability to establish rapport with physicians and other healthcare practitioners
- Must have strong analytical and critical thinking skills to support problem solving and associated change management.
- Must be able to successfully pass the Basic Microsoft Office Skill Assessment at 80% or higher rating during pre-employment interview process
- Manages the daily operations of the Hospital Coding Department to promote steady work flow and data integrity.
- Manages the daily operations of the Physician Practice Coding Department to promote steady work flow and data integrity.
- Research coding questions and provide coder feedback - Ensures timely correction of coding errors and edits.
- Ensures coding audits are performed concurrently and that the areas being audited are updated in conjunction with the department policies.
- Oversees the monitoring of the aging and DNB accounts to ensure that accounts are coded in a timely manner and that performance is within established coding quality and productivity benchmarks.
- Conducts regular audits and coordinates monitoring of coding accuracy, productivity, and available clinical documentation.
- Ensures that audit reports are reviewed, accurate, and corrective action plans implemented.
- Provides feedback and assists in facilitating and/or coordinating focused educational programs regarding coding and clinical documentation best practices to Coding and clinical staff as needed.
- Interviews, hires and trains employees; plans, assigns and direct workflow, appraises employee performance; addresses complaints and resolving problems; and proactively manages production and quality control efforts.
- Conducts trend analysis to identify patterns and variations in coding/documentation practices and case mix index.
- Identifies process improvement opportunities within the Coding department and implements solutions.
- Reviews claim denials and rejections pertaining to coding and medical necessity issues and implements corrective action plans as needed/required.
- Works with Coding Supervisors to provide all Coding staff with annual, quarterly, semi-annual ICD-10-CM/PCS and/or CPT code changes and coordinates with Information Systems & Technology to ensure timely system updates.
- Maintains all coding information and provides updated manuals, resources, and other coding material.
- Monitors, verifies and reconciles expenditures of budgeted funds, compiling information reflecting expenditures, and develop cost- comparisons. - Identify cost savings within the operation.
- Actively participates in the Internal Audit Process exit conferences, providing clarification and supporting information necessary.
- Collaborates with other coding managers outside of the organization to ensure consistent implementation of coding policies, procedures, and practice - Maintain strong communication with Director(s) and business partners in reporting of unbilled activities related to coding.
- Mentors team members to encourage personal and professional growth.
- Encourages ongoing skill development by providing opportunities for continued education.
- Applies critical thinking, problem solving and change management skills to lead the process and team in identifying and resolving systemic issues.
Safety: Practices proper safety techniques in accordance with hospital and departmental policies and procedures. Responsible for the reporting of employee/patient/visitor injuries or accidents, or other safety issues to the supervisor and in the occurrence notification system.
Compliance: Monitors and ensures compliance with all regulatory requirements, organizational standards, and policies and procedures related to area of responsibility. Identifies potential risk areas within area of responsibility and supports problem resolution process. Maintains records of compliance activities and reports compliance activities to the Compliance Office.
The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be an exhaustive list of all job duties performed by the personnel so classified.
Ability to lift up to 15 lbs independently not to exceed 50 lbs without assistance
Bending/Stooping - Occasionally (activity or condition exists up to 1/3 of time)
Climbing - Occasionally (activity or condition exists up to 1/3 of time)
Hearing/Speaking - Effective communication with employees, supervisors/managers and staff. Effective communications with patients and visitors, as required.
Lifting - Occasionally (activity or condition exists up to 1/3 of time)
Pushing/Pulling - Occasionally (activity or condition exists up to 1/3 of time)
Sitting - Constantly (activity or condition exists 2/3 or more of time)
Standing - Occasionally (activity or condition exists up to 1/3 of time)
Walking - Occasionally (activity or condition exists up to 1/3 of time)
No potential for exposure to blood and body fluids
Children’s Healthcare of Atlanta has been 100 percent committed to kids for more than 100 years. A not-for-profit organization, Children’s is dedicated to making kids better today and healthier tomorrow.
With 3 hospitals, 20 neighborhood locations and a total of 673 beds, Children’s is the largest healthcare provider for children in Georgia and one of the largest pediatric clinical care providers in the country. Children’s offers access to more than 60 pediatric specialties and programs and is ranked among the top children’s hospitals in the country by U.S. News & World Report.
Children’s has been recognized as a Fortune 100 Best Place to Work, a Best Place for Working Mothers, and as a top employer for diversity and millennials. We offer a comprehensive compensation and benefit package that supports our mission, vision and values. We are proud to offer an array of programs and services to our employees that have distinguished us as a best place to work in the country. Connect to our mission of making kids better today and healthier tomorrow.