Full Job Description
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Work Shift
Day
Work Day(s)
Monday-Friday
Shift Start Time
8:00 AM
Shift End Time
4:30 PM
Worker Sub-Type
Regular
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.
Experience
- 3 years of experience in health information management or coding management in a hospital or physician practice/clinic setting
Preferred Qualifications
- N/A
Education
- Associates degree in Health Information Management/Health Information Technology, or related healthcare field, or 3 years of managerial experience in Health Information Management or Coding
Certification Summary
- Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Specialist 6 Physician (CCS-P), or Certified Professional Coder (CPC)
Knowledge, Skills, and 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
Job Responsibilities
- Manages the daily operations of the Hospital Coding Department to promote steady workflow and data integrity.
- Manages the daily operations of the Physician Practice Coding Department to promote steady workflow 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.
Primary Location Address
Used for remote worker assignment
Job Family
Coding