Responsible for supervision of all
facets of charge capture and coding, including charge review and coding related
ESSENTIAL JOB FUNCTIONS:
1. Ensures the timely and accurate capture
of charges, and submission of clean claims.
2. Ensures that physician documentation
supports medical necessity and substantiates services provided.
3. Leads and participates in ad hoc teams
to improve coding and charge capture processes.
4. Works collaboratively with audit and
compliance teams to educate providers on the appropriateness of coding and
5. Monitors coding denials to identify
potential problem areas and takes prompt, effective action to ensure timely,
6. Monitors work production and quality of
coding and charge capture.
7. Recommends the development of Epic
Charge Router rules and Charge Review edits to ensure that charges are correct
prior to billing.
8. Monitors workflows and
system-enhancement opportunities to optimize efficiency and effectiveness.
9. Develops, maintains, and assures
compliance with Policies and Procedures for the team.
10. Obtains and maintains proficient level
of knowledge (eg., Epic ARCR Certification) of applicable Epic tools to ensure
continued enhancement to people, process and technology.
11. Makes hiring recommendations and
evaluates performance of direct reports.
12. Coordinates staff schedules to assure
adequate coverage to meet performance expectations.
13. Works collaboratively with the rest of
the management team to improve processes and meet goals.
14. Responsible for employment and selection
decisions. Completes and forwards employment requisitions for personnel
replacements to Human Resources. Interview, checks references and makes
hiring decisions for new employees in coordination with PFS Manager and Human
Resources. Partners with PFS Manager and Human Resources to resolve
compensation issues and determine starting pay for new hires.
15. Recommends changes to policies and
procedures as needed.
16. Researches and arranges coding
to work independently in a multi-task environment.
to weight pros and cons of decisions and make sound recommendations.
3. Strong customer service and
interpersonal communication skills, both verbally and in writing. Ability to
foster teamwork and communication in others and handle sensitive
4. Develops strong relationships with all
departments to develop coding and reimbursement training materials and to
to solve difficult coding and reimbursement problems effectively, using empathy
to analyze problems and resolve independently or in collaboration with others.
of organizational policies, regulations and procedures to complete decisions
to consistently present a professional image and positive attitude when dealing
with clinicians and employees on coding and reimbursement issues.
to inspire and motivate clinicians and the patient accounts staff to perform at
a high level of excellence in coding and auditing.
10. Ability to consistently consider the effect of actions on others and the
11. Ability to persist in dealing with
12. Initiative to remain up to date on
coding and insurance billing changes, reimbursement and collection laws and
13. Ability to conduct effective team
meetings and manage on-going education for the team.
14. Ability to supervise remote staff.
15. Ability to prioritize workload and
follow through on assignments.
16. Demonstrates accountability and
responsibility for own work and work of team.
17. Ability to inspire and motivate the
staff they lead to perform at a high level of excellence.
18. Ability to be flexible in adapting to
19. Commitment to ongoing professional
20. Participates and works with other
Managers and Supervisors in developing good working relationships and processes
throughout the Clinic.
School diploma or GED required. Certification as Professional Coder (CPC)
required, OB/GYN certification preferred.
2. Experience with EPIC software preferred,
ideally in an OB/GYN clinic.
3. Minimum two years supervisory experience
in a medical physician office facility.
4. Minimum two years in medical practice
billing, coding and collections.
5. Advanced working knowledge of medical
6. Advanced and current knowledge of CPT,
and ICD-10 coding.
7. Current knowledge of insurance payer
coding and reimbursement guidelines.
8. Ability to identify, initiate, implement
and manage business practices, policies and processes.
9. Proficient organizational skills,
attention to detail and accuracy.
10. Demonstrated ability to establish and
maintain effective working relationships with internal and external parties.
11. Ability to exercise initiative,
problem-solving and decision making.
12. Excellent interpersonal and
13. Demonstrated customer service oriented
14. Demonstrated success in service
excellence and quality improvement.
15. Valid driver’s license and the ability
to drive to various WHA sites and meetings.