Enterprise Professional Coding Audit and Education Supervisor

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Supervises hospital or professional coding staff and assists the management team in the day-to-day operations of the department, as it pertains to reimbursement, coding, abstracting, and education. Will assist with the implementation and facilitation of ongoing medical coding/abstracting, auditing, monitoring, and physician/coder educational activities for existing and new clinics, locations and hospitals. The duties of this position will help ensure that we remain in compliance with all federal and state coding healthcare rules, regulations, administrative requirements and guidance. Serves as a positive role model for all staff and a representative of department.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

EXPERIENCE:

1. Five (5) years of medical coding experience.

PREFERRED QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Associates degreeor higherin Health Information Management or related field.

EXPERIENCE:

1. Previous clinical experience, as an RN, LPN or Medical Assistant, highly desirable.

2. Extensive experience in ICD-10-CM, ICD-10-PCS, CPT, and MS-DRG, HCC and APR-DRG assignment for Hospital Supervising Positions and multi-specialty coding, E&M coding, procedural/surgical coding, as well as knowledge of governmental billing and coding regulations including the “Teaching Physician Guidelines” for Professional Coding Supervisors.

3. Previous supervisory or project management experience.

4. Seven (7) years of medical coding experience preferred.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position.  They are not intended to be constructed as an all-inclusive list of all responsibilities and duties.  Other duties may be assigned.

1. Supervises coding staff and assists the management team in the day-to-day operations of the department, as it pertains to reimbursement, coding, abstracting, productivity, quality and education.

2. Ensures that all coding backlogs, work queues and charge lag remains at acceptable levels.

3. Acts as expert coding resource not only to coders, providers and revenue cycle, but also to specialty groups and meetings.

4. Responsible for personnel management of coding staff, including but not limited to, interviewing, hiring, coaching and counseling, discipline and performance evaluation in conjunction with management.

5. Develops and maintains coding related policies, procedures, and training materials in conjunction with management.

6. Identifies budgetary needs and maintains fiscal stewardship.

7. Conducts and/or oversees internal and external auditing to determine compliance with medical record documentation, coding and billing guidelines.

8. Works with staff to analyze and resolve issues that impact coding and billing.

9. Maintains effective, open and ongoing communication.

10. Extracts, analyzes and reports data to appropriate management team.

11. Serves as a liaison to vendors and provides input and tests information systems.

12. Assists in staff coding, as needed.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Must be able to sit for long periods of time.

2. Must have visual and hearing acuity within the normal range.

3. Must have manual dexterity needed to operate computer and office equipment.

4. Must be Able to lift, push or pull 10-20 pounds.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Standard office environment.

2. Visual strain may be encountered in viewing computer screens, spreadsheets, and other written material.

3. May require travel.

SKILLS AND ABILITIES:

1. Must possess excellent written and verbal communication skills, as well as interpersonal skills necessary to communicate effectively.

2. Must possess the knowledge of related provider healthcare compliance, revenue cycle operations, and auditing techniques required.

3. Must possess the ability to mentor, educate and train others.

4. Must ensure quality and productivity standards.

5. Must be able to handle high stress and critical situations in a calm and professional manner

6. Must be able to concentrate and maintain accuracy during constant interruptions.

7. Must possess independent decision-making ability.

8. Must possess the ability to prioritize job duties.

9. Must be able to adapt to changes in the workplace and work assignments.

10. Must possess organizational and time management skills.

11. Must possess the knowledge of anatomy, physiology and medical terminology.

12. Must possess analytical and problem solving skills.

13. Must be proficient in office software programs, including medical record and billing systems.

14. Must possess the ability to analyze complex data and reports.

Additional Job Description:

Scheduled Weekly Hours:

40

Shift:

Exempt/Non-Exempt:

United States of America (Exempt)

Company:

SYSTEM West Virginia University Health System

Cost Center:

539 SYSTEM HIM Provider Based Coding Analysis