Senior Coding Manager

Alaska Native Medical Center   •  

Anchorage, AK

Industry: Hospitals & Medical Centers

  •  

5 - 7 years

Posted 48 days ago

JOB SUMMARY: Under limited supervision, functions as the Manager of all Coding activities including, but not limited to, Inpatient, Day Surgery, Observation, and Diagnostic Facility and Professional Fee Coding and lead support to the Revenue Integrity Program.

The following duties are intended to provide a representative summary of the major duties and responsibilities and ARE NOT intended to serve as a comprehensive list of all duties performed by all employees in this classification. Incumbent(s) may not be required to perform all duties listed and may be required to perform additional, position-specific duties.

REPRESENTATIVE DUTIES

Establishes standards and guidelines related to: internal quality reviews, compliance initiatives, reporting initiatives, benchmarking, research and analysis, continuous improvement opportunities, financial and strategic planning, and other customer requested projects. Works collaboratively leading and participating in projects and multi-disciplinary workgroups. Identifies patterns, trends and variations in the facility's coding and documentation practices. Provides feedback and updates on quality improvements, trends, issue resolution and implementing changes. Evaluates the root cause and takes appropriate steps in collaboration with the right individual or department to effect resolution or explanation of the variances.

Develops, implements and maintains a standardized, organizational wide, quality data management plan for coding and reimbursement, health records and documentation to ensure compliance with external regulatory and accreditation requirements. Participates in the Coding / Billing Compliance Plan/ Program.

Compiles and analyzes data for documentation and coding quality and productivity. Plans, schedules and performs concurrent and retrospective audits of inpatient, day surgery, observation and ancillary encounters assessing the documentation against the coded diagnoses and procedures. Leads documentation, coding, and billing relationships related to clinicians, other departments, finance and administration. Investigates, resolves and monitors data quality issues and improvement. Maintains coding data quality, coding education and validation in accordance with State and Federal regulations.

Manages and schedules assigned staff that includes Contract coding staff. Develops goals and priorities; assigns tasks and projects. Identifies, researches, and resolves coding issues. Develops staff skills and training plans. Counsels, trains and coaches assigned staff. Implements corrective actions and conducts performance evaluations. Performs timekeeping duties. Provides leadership, direction and guidance. Oversees and directs at least one Supervisor and other Leads.

Represents the department on various committees; conducts regular staff meetings. Works collaboratively with other Staff, Managers, and Directors Develops, implements and maintains a standardized, organizational wide policies and procedures to monitor the success of the data quality management plan, review areas of risk, investigate risk factors in coding and documentation practices and report data analyses.

Develops and implements standardized organization-wide coding guidelines and documentation requirements. Develops and implement training and educational programs for providers and coders.

Educates medical staff on monitoring and identifying deficiencies to improve performance. Reports summary of documentation deficiencies and progress in improvements to management. Provides SENIOR CODING MANAGER Page 2 of 3

consulting services in the area of data quality management to individuals, special projects, and executive and clinical departments throughout the organization.

Assists as a subject matter expert (SME) for Coding workflows in the Electronic Health Record (EHR) and associated Coding tools and software.

Assists with requests to review and verify codes, charges on patient accounts and denials. Responsible for the implementation and education on system changes and new requirements.

Develops and adheres to Operational budget and other metrics such as Staffing, Productivity, Coding Quality, and Uncoded/Discharged Not Final Billed (DNFB).

Provides feedback and education to physician and professional staff regarding changes in coding methodology and enhanced documentation procedures for optimizing reimbursement. Maintains the confidentiality of patient records and procedures.

Performs other duties as assigned.

KNOWLEDGE and SKILLS

Knowledge of medical terminology and abbreviations; anatomy and physiology; major disease process and pharmacology.

Knowledge of classification systems CPT, E&M, ICD, and HCPCS nomenclature, coding rules and guidelines.

Knowledge of coding conventions and rules established by the American Medical Association (AMA), the Center for Medicare and Medicaid (CMS), AHIMA, and AAPC for assignment of diagnostic and procedural codes.

Knowledge of Health Information Management theory, principles, practices, techniques, concepts and policies.

Knowledge of the Privacy Act of 1974, HIPAA Privacy Rule of 1996 and CMS Conditions of Participation Knowledge of coding software.

Knowledge of health care operations; ethical coding principles; and revenue cycle activities.

Knowledge of auditing principles and standards.

Knowledge in developing and conducting training/educational sessions for diverse audiences.

Skill in effectively managing and leading staff, and delegating tasks and authority.

Skill in assessing and prioritizing multiple tasks, projects and demands.Skill in reading medical records, and finding and resolving documentation discrepancies.

Skill in understanding medical billing procedures and protocols.

Skill and judgment in applying appropriate codes to diagnosis, procedures, evaluation and management, and supplies.

Skill in operating a personal computer utilizing a variety of software applications.

Skill in operating computerized medical coding and information processing systems.

Skill in operating a personal computer utilizing a variety of software applications.

Skill in oral communication and presenting information to providers.

Skill in writing technical reports and other materials for presentation.

Skill in receiving and disseminating information effectively and appropriately.

Skill in using analytical and research skills to define and solve problems.

Skill in assessing and prioritizing multiple tasks, projects and demands and effective project management.

Skill in interpreting and applying ethical coding standards, federal and state laws and regulations; rules; policies and procedures; and professional practice standards for health care organization coding compliance program activities.

SENIOR CODING MANAGER Page 3 of 3

 

Skill in medical record auditing and results reporting.

Skill in establishing and maintaining cooperative working relationships with other employees, leader sand medical staff members

Required Skills

Knowledge of medical terminology and abbreviations; anatomy and physiology; major disease process and pharmacology.

Knowledge of classification systems CPT-4, E&M, ICD-9-CM, and HCPCS nomenclature, coding rules and guidelines.

Knowledge of coding conventions and rules established by the American Medical Association (AMA), the Center for Medicare and Medicaid (CMS), AHIMA, and AAPC for assignment of diagnostic and procedural codes.

Knowledge of Health Information Management theory, principles, practices, techniques, concepts and policies.

Knowledge of the Privacy Act of 1974 and HIPAA Privacy Rule Act of 1966.

Knowledge of coding software.

Knowledge of health care operations; ethical coding principles; and revenue cycle activities.

Knowledge of auditing principles and standards.

Knowledge in developing and conducting training/educational sessions for diverse audiences.

Skill in effectively managing and leading staff, and delegating tasks and authority.

Skill in assessing and prioritizing multiple tasks, projects and demands.

Skill in reading medical records, and finding and resolving documentation discrepancies

Skill in understanding medical billing procedures and protocols.

Skill and judgment in applying appropriate codes to diagnosis, procedures, evaluation and management, and supplies.

Skill in operating a personal computer utilizing a variety of software applications.

Skill in operating computerized medical coding and information processing systems.

Skill in operating a personal computer utilizing a variety of software applications.

Skill in oral communication and presenting information to providers.

Skill in writing technical reports and other materials for presentation.

Skill in receiving, disseminating information effectively and appropriately.

Skill in using analytical and research skills to define and solve problems.

Skill in assessing and prioritizing multiple tasks, projects and demands and effective project management.

Skill in interpreting and applying ethical coding standards, federal and state laws and regulations; rules; policies and procedures; and professional practice standards for health care organization coding compliance program activities.

Skill in medical record auditing and results reporting.

Required Experience

MINIMUM EDUCATION QUALIFICATION

A Bachelor's degree in health information management (HIM). An Associate's degree in HIM and two (2) years progressively responsible HIM-related work experience training may be substituted for Bachelor's degree.

MINIMUM EXPERIENCE QUALIFICATION

Non-supervisory – Six (6) years experience working in the health information management field.

AND

Supervisory – Three (3) years experience involving employee supervision in the health information management field.

MINIMUM CERTIFICATION QUALIFICATION

Must possess and maintain Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) credential.

CPC or CCS required.

PREFERRED EDUCATION QUALIFICATION

N/A

PREFERRED EXPERIENCE QUALIFICATION

N/A

PREFERRED CERTIFICATION QUALIFICATION

N/A

ADDITIONAL REQUIREMENTS

Depending on the needs of the organization, some incumbents in this job class may be required to obtain additional certifications or training in one or more specialty areas.

WORKING CONDITIONS

The following demands are representative of those that must be met by an employee to successfully perform the essential functions of this job:

ANMC is not a latex free facility; an employee should expect to work in an environment where latex may be present.

May be required to work outside the traditional work schedule.

This position requires persistent repetitive movements of the hands, wrists and fingers and the ability to sit for long periods of time. May occasionally be exposed to infectious diseases.

This job description is not an employment agreement or contract. Management has the exclusive right to alter this job description at any time without notice.

Signature below acknowledges that I have received a copy of my job description and my supervisor has discussed it with me.