Responsible for planning, organizing and supervising staff to ensure timely and appropriate documentation and coding to support a complete and accurate clinical picture, comorbidity/complication capture rates, mandated reporting, quality measures, compliance and reimbursement. Collaborates with other departments to assist in development, promotion, and maintenance of the revenue cycle, quality programs and services. Participates in the coordination of the Clinical Documentation Improvement Program (CDIP).
Post Secondary Education or equivalent
3 to 5 years Supervisory/management experience
4 years direct experience
Certified Coding Specialist (CCS) or equivalent; Clinical Documentation Specialist (CCDS) preferred
Strong communication skills; demonstrated ability to effectively lead a team as well as be a team member; ability to embrace change, make independent decisions and multi-task with high attention to detail.
1. Oversees and leads staff, ensuring consistency with department and hospital policies. Coaches and assists in developing team members; disciplines, manages performance and counsels staff as necessary. Maintains current job descriptions and monitors staff goals and objectives regularly. Ensure all departmental initiatives support the mission, vision and values of the organization.
2. Applies broad guidelines to specific coding situations. Proficient in ICD 10 CM and CPT coding classification systems, diagnosis and procedure selection, and sequencing guidelines and coding clinics.
3. Coordinates the communication, filing, and distribution of Medicare's LMPs & Bulletins. Meets with Department Directors to communicate documentation requirements to provide compliance with LMRPs/Bulletins.
4. Coordinates the follow up to issues generated by the Patient Accounts Department (denials, charge corrections, coding questions, backlogs).
5. Provides training and oversight to coders in all levels. Conducts performance evaluations with Director oversight. Manages the distribution of work for the coding team including vendor support as needed. Assists with determining coverage needs during other coders planned and unplanned absences.
6. Demonstrates skill with DRG and APR assignment, as well as, determining Present on Admission Indicators. Demonstrates competence with Coding Guidelines and knowledge of APC prospective payment systems.
7. Assist all Coders with claims resolution and by monitoring the Coders Mailbox for identification of accounts that need additional follow up.
8. Assist the Director in managing the CDIP and education initiatives. Attends all meetings and creates Agendas and minutes. Coordinates and participates in testing updates to the Meditech ABS module and assists with IT issues when needed.
9. Performs and/or coordinates all internal and external audits as assigned by the Director of Medical Records and performs other duties as assigned.