Compliance Coding Audit Manager Job in Fort Myers, Florida

The Compliance Coding Audit Manager is responsible for coordinating the day-to-day operations of the coding auditor staff. Accurately follows all applicable federal, state and local guidelines for the processing of patient information.  Recommends individuals for hire or termination; completes evaluations, commendations and counseling of direct reports; and oversees the work of all employees within span of control.   Coordinates with the Chief Compliance, Ethics & Risk Officer to ensure sufficient staffing to maintain consistent, efficient and effective functions of the department.  Manages documentation of the employee training process; orients new staff to the department and ensures that all employee files are maintained in accordance with organizational policies.  Conducts ongoing quality reviews and system maintenance of data/reports generated and reported from systems used within area of responsibility. Assists the Chief Compliance, Ethics & Risk Officer with the development of quality, performance and productivity standards for department, assists with ensuring all functions/work are reviewed on a regular, ongoing basis and reported to management.  Coordinates with the Coding Education Manager on audit trends to enable appropriate identification of educational needs for both providers and internal teams.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Supervises and performs a wide range of activities pertaining to the review and coding/billing of inpatient and outpatient medical record information for Millennium’s healthcare providers and patients.
• Oversees the daily performance of the Compliance Coding Auditors in all assigned duties.
• Coordinates with the Chief Compliance, Ethics & Risk Officer to ensure organizational, departmental and individual benchmarks are met.
• Coordinates with the Coding Educator on all data to ensure appropriate education is identified for providers and internal teams.
• Oversees the continuous evaluations of the quality of clinical documentation to identify incomplete or inconsistent documents for inpatient and/or outpatient encounters that impact the code selection and resulting APC/DRG groups and payment; brings concerns to the attention of the Coding Manager.
• Maintains knowledge of current and required coding certifications as appropriate; may perform the most technical complex and difficult coding and abstraction work.
• Selects, assigns, and trains subordinate coding and clerical staff; directs, monitors and evaluates work; reviews and makes decisions regarding leave requests; initiates and implements disciplinary action as needed; assists with and promotes the recruitment and retention of qualified staff as assigned.
•  Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association; reports areas of concern to the Compliance Officer
• Assists the Coding Manager by serving as a department representative by attending coding and reimbursement workshops and bringing back information as appropriate; communicates any updates published in third-party payer newsletters, bulletins and/or provider manuals; shares information with facility staff as directed.
• Stays informed about transaction code sets, Health Insurance Portability and Accountability Act (HIPAA) requirements and other future issues impacting health information management functions; keeps abreast of new technology in coding and abstracting software and other forms of automation.
• Demonstrates and maintains competency in the use of computer applications.
• Monitors unbilled account reports, hold lists etc.; for claims awaiting coder review and facilitates the delegation of work in an effort to reduce accounts receivable days for these claims.
• In partnership with appropriate personnel, recommends opportunities for standardized, organization-wide coding guidelines and documentation requirements (Coding Alerts).
• Project management of multiple initiatives with ability to prioritize and meet deadlines.
• Clear, concise and professional communication to varying audiences dependent on the project and its goals.
• Time management, meetings, travel and deadlines may require hours outside standard 40-hour work week.

Manager Responsibilities:

Directly supervises assigned employees in the Compliance Department. carries out Manager responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

Please see full description and apply here:

http://tempuri.org/tempuri.html