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.