JOB SUMMARY:
The Coding Manager is responsible for
the accurate and effective coding of all OSS Health services. This role includes the oversight of all
coding staff, education and educator positions including the auditing of their
performance and productivity. The
manager will provide hands on support, represent the department at meetings,
and provide physician education in interpretation, coding compliance and
documentation improvement. Works with external auditing companies engaged with OSS Health.
QUALIFICATIONS
AND EDUCATION:
Education:
· High School Diploma or equivalent required; Bachelor’s
Degree preferred.
·
Current CPC or
CCS certification required.
·
CPMA and/or CCP certification preferred.
· Member
in good standing with AHIMA and/or AAPC.
Experience:
· Minimum of 5 years of
experience with Medical Coding, including but not limited to acute care
hospital inpatient, outpatient, surgical and professional fee (evaluation and
management). Orthopedic experience
preferred.
· Proven project
management skills with the ability to analyze, develop and implement new
processes and procedures.
· Working knowledge of
ICD-10 required, knowledge of anatomy and physiology, CPT, Coding guidelines
and methodologies, DRG, APC, NCCI, LCD, NCD, MCC.
· Ability to investigate
denials, RAC audits and other audits accurately and in a timely fashion.
· Must possess
proficient computer skills and oral and written communication skills.
· Must have effective
supervisory experience.
· Must be able to
prioritize, delegate and organize heavy workload. Must be able to work effectively on multiple
projects at one time.
ESSENTIAL DUTIES AND
RESPONSIBILITIES:
·
Ensures that all coding activities meet all
compliance guidelines and are in line with appropriate practice in all OSS
Health specialties.
· Monitors
coding levels used among OSS providers and deviation of same from expected
distribution, as compared to each other as well as external sources.
·
Communicates
with patients and/or insurance companies when high-level issues arise.
·
Other
duties as assigned.
SUPERVISORY
RESPONSIBILITIES:
Directly supervises
Charge Posters, Coding Specialists, Coding/Auditor Educator and Coding
Compliance Educator.
- Functions as a coach & mentor to the staff for whom this
position is responsible.
- Participates in and/or supports the employment process in
conjunction with the Human Resources Department.
- Submits requests for staffing needs on a thorough and timely
basis, securing all necessary approval(s).
- Participates in the screening/interviewing process, making self
available to meet the candidates’ needs to expedite the screening
process.
- Participates in and/or supports the Orientation of newly hired
staff members.
- Provides and/or oversees the training of newly appointed staff
members (to the department).
- Develops and/or maintains on-going training programs/initiatives to
enhance skills, knowledge and productivity of existing employees.
- Participates in training sessions as required and/or deemed
necessary.
- Provides leadership and direction to the staff for whom responsible
in order to maintain a work environment that promotes the creative
development of ideas and allows employees to meet and/or exceed
expectations and established standards of performance.
- Monitors and measures performance of those staff reporting to this
position. Addresses concerns or
weaknesses and takes appropriate action to ensure issues are resolved.
Ensures that staff are working as efficiently, as accurately and as
productively as possible.
- Ensures the compliance and/or oversees the compliance with all
policies and procedures by staff.
Recognizes exemplary compliance.
Initiates appropriate corrective action in instances of
noncompliance; secures required approvals before addressing with the
staff.
- Makes decisions and takes actions essential to the daily operation
of the work area(s) for which responsible.
- Maintains or oversees the maintenance of supplies deemed necessary
for the efficient operation of the area(s) for which responsible.
- Research major expenditures (including equipment, supplies and/or
systems) and make recommendations to the appropriate member(s) of
management for approval to purchase.
LANGUAGE
SKILLS:
Ability
to communicate effectively with staff, peers, physicians and the public.
Ability to speak and understand English fluently.
PHYSICAL DEMANDS:
Must
be able to work under stress and in a fast-paced environment. Must be able to work under conditions that
require sitting, standing, walking, lifting, bending, reaching, pulling,
fingering, grasping, talking, hearing and seeing.
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.
WORK ENVIRONMENT:
Climate controlled environment with occasional
periods of being outside.
The
above statements reflect the general duties considered necessary to describe
the principle functions of the job as identified, and shall not be considered
as a detailed description of all work requirements that may be inherent in the
position.