The Audit, Education, Analytics, & Technology Supervisor, in conjunction with physicians, coders, and clinical staff, will utilize documentation and coding expertise to facilitate the quality and completeness of medical record documentation of outpatient encounters, including but not limited to clinic visits, outpatient surgical procedures, telemedicine, and other ancillary services. Through concurrent, prospective, and retrospective evaluation and assimilation of the medical record along with communication with physicians and other clinicians, the Supervisor will be responsible for achieving improved documentation results for the organization. The outcome will be documentation that accurately and completely captures the clinical picture/severity of illness/complexity of the patient while providing specific and complete information to be utilized in coding, profiling and outcomes reporting of both the facility and the physicians. The Supervisor utilizes knowledge of national coding guidelines (ICD-10), CPT, Hierarchical Condition Categories (HCC), standards of compliance, and clinical knowledge to identify opportunities and to achieve results.
EDUCATION AND EXPERIENCE:
- Bachelors degree (Business Administration or Healthcare related field) or 5 years medical billing, coding, auditing, compliance, CDI, revenue integrity, healthcare/business financial or other revenue cycle experience, including at least 1-2 years lead role or supervisory experience may be considered in lieu of education requirement.
- Must have a thorough knowledge of anatomy, physiology, pathophysiology, disease processes, medical terminology, pharmacology, and coding systems.
- Additional specialty coding certification or 5-7 years coding experience required.
- Data analytics experience preferred.
- Ability to build relationships, negotiate processes and outcomes, and influence behaviors.
- Knowledge of health care fiscal management goals and strategies, including but not limited to trends and issues in health care reimbursement, coding guidelines, and case management.
- Knowledge of electronic medical record systems and demonstrated proficiency of Microsoft Office.
- Ability to work and lead remote employees.
- Ability to withstand pressure of deadlines, multitask, prioritize, adapt to change, and receipt of work with variable requirements.
- Ability to work in a highly matrixed environment.
- Ability to work independently, be resourceful, and possess strong organizational skills.
- Ability to communicate effectively to physicians and other clinical staff; be courteous, tactful, and cooperative.
- Ability to use critical thinking and appropriate judgement throughout all phases of work.
CERTIFICATIONS & LICENSURES REQUIRED:
- At least one of the following certifications is required: CPC, CCS, CCS-P, CCDS, CDIP, RHIT or RHIA.
