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Coding Compliance Manager Job in Fairborn, Ohio

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Job Title: Coding Compliance Manager

Employer:Wright State Physicians
Location: Fairborn 45324, OH, US
Date Posted:11/6/2020

General Summary:  An exempt position providing leadership and vision for strategic planning and quality improvement projects and initiatives. Serves as liaison to Wright State Physicians administration, medical staff, and third parties. 


Essential Job Responsibilities:

1.     Oversees the operation of the clinical coding and compliance areas within Wright State Physicians, including inpatient/outpatient coding, clinical data abstraction, report writing, and HIPAA compliance. 

2.     Reviews billing requirements and develops and maintains policies and procedures that support clinical coding and compliance, and ensures appropriate coding of services.

3.     Collaborates with the medical staff and departments to ensure the quality and consistency of clinical documentation.

4.     Coordinates audits of coding and documentation practices and initiates continuous improvement activities to ensure coding compliance with regulatory requirements.

5.     Conducts education and training programs to keep staff, providers and departments current on coding, reimbursement, compliance and regulatory changes and procedures.  Assesses staff educational needs and plans appropriate methods to meet developmental needs, including resident training, as appropriate.

6.     Continuously assesses functional work processes, initiating changes as needed to improve efficiency and effectiveness, and moves the clinical coding functions toward industry best practices.

7.     Manages employees (direct reports) including, counseling, conducting performance appraisals, interview, etc. and provides instruction to staff and management as necessary.   

8.     Monitors quality and productivity of staff including audits on staff work.

9.     Monitors and reports key financial and operational indicators related to coding and identifies trends, issues and risk areas to improve performance. 

10.  Collaborates with other staff and departments to continually improve the flow of patient information and resolve issues or inconsistencies with coding compliance, charge capture and data/information.

11.  Collaborates with internal and external customers to define abstract data elements; establishes policies and procedures related to data capture, retention, and retrieval; assists end users in translating data into useful information.

12.  Remains current on all coding, reimbursement and compliance guidelines. 

13.  Utilizes automation and computer systems effectively to maintain privacy and maximize productivity, quality, and customer service.

14.  Manages the implementation of new coding rules and all other coding related changes.

15.  Other duties assigned 

Education/Certifications:  Bachelor’s degree or the equivalent combination of education and experience is required in Health Information or related field preferred. Requires Certified Coding Specialist (CCS or CCS-P); or Certified Professional Coder (CPC). Certified Professional Medical Auditor (CPMA) recommended 

Experience: Minimum 2 years clinical coding supervisory and acute care coding experiences required. 

Other Requirements: 

1.     The employee is expected to protect the privacy of all patient/client information in accordance with Wright State Physicians privacy policies, procedures and practices as required by Federal (and State) law and in accordance with general principles of professionalism as a health care provider.  Maintain knowledge of CMS’s incentive program standards and other payers’ quality programs.  Possess strong communication and presentation skills.

2.     Maintains the confidentiality of all patient/staff records.

3.     Active participant with teams involved with process improvements.

4.     Keeps abreast of and ensures compliance with regulatory guidelines, accreditation bodies and system policy/procedure for all activities within practice.

5.     Maintains communication with leaders on an ongoing basis to review performance targets as well as other projects as defined by the Medical Group Executive and the Director of Revenue Cycle.

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