Core - Coding Manager in Exeter, NH - Exeter Hospital Career Site Core - Coding Manager in Exeter, NH - BlackBear Communications

Core - Coding Manager

  • Exeter, NH
  • Core Physicians LLC
  • full time
  • Req #: 12141
  •  Day Shift - M-F, 8:00-5:00. Others as needed.
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Summary

Live, work, and play on the beautiful New Hampshire Seacoast

Seacoast New Hampshire welcomes you to live, work and play. With local access to the outdoors, including the ocean, lakes region and mountain terrains, the Seacoast also offers a culture rich in history, arts and dining. Tree-lined main streets in many of our communities have grown from small colonial villages and continue to be populated with locally owned shops and restaurants that radiate quintessential New England town. Meanwhile, Boston, MA and Portland, ME are less than an hour away. The area boasts high quality public school systems, while also offering Phillips Exeter Academy, University of New Hampshire and Dartmouth College nearby.  There is something for everyone in the “Live Free or Die” State! Come Join Us!

Summary of position:

Plan, organize, and manage the coding unit to meet the organization’s mission. Ensure that accurate, coded data exists for optimal reimbursement by the organization, and coordinate all quality and compliance monitoring of assignments for outpatient professional and technical services.

Requirements:

  • 5 to 7 years of supervisory/management experience
  • Bachelor’s Degree
  • Certified Professional Coder (CPC) or (CCS) or equivalent professional certification
  • CRC certification
  • Strong analytical skills
  • Strong communication skills
  • Extensive experience with HCC coding and compliance including RCX rules
  • Certification and five years of healthcare professional coding (inpatient and outpatient)

Major Responsibilities:

  1. Oversees the daily operations of the coding unit including workload and staffing; hiring, disciplining, and performance appraisals; training; and monitoring quality of work.
  2. Develops long-range and short-term goals, objectives, plans, and programs and ensures they are implemented.
  3. Assists in planning, developing, and controlling the budget, including staffing costs, capital equipment, and operations of the coding unit.
  4. Evaluates the impact of innovations and changes in programs, policies, and procedures for the coding unit. Designs and implements systems and methods to improve data accessibility. Identifies, assesses, and resolves problems. Prepares administrative reports.
  5. Oversees and monitors the coding compliance program. Develops and coordinates educational and training programs regarding elements of the coding compliance program such as appropriate documentation and accurate coding to all appropriate staff.
  6. Conducts and oversees coding audit efforts and coordinates monitoring of coding accuracy and documentation adequacy. Reports noncompliance issues detected through auditing and monitoring, the nature of corrective action plans, and the results of follow-up.
  7. Conducts trend analyses to identify patterns and variations in coding practices and case-mix-index. Compares coding and reimbursement profile with national and regional norms to identify variations requiring further investigation.
  8. Reviews claim denials and rejections pertaining to coding and medical necessity issues and, when necessary, implements corrective action plan (such as educational programs) to prevent similar denials and rejections from recurring.
  9. Interacts with a variety of people who impact the success of coding compliance program, and functions as a facilitator, liaison, and/or motivator.
  10. Assesses and continually develops software systems used to enhance coding efficiencies (i.e. RCX rules).
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