Coding Manager - PB

JOB DETAILS
Department: Middle Revenue Administration
FTE: 1.00 (80 hours per pay period)
Workdays: Monday - Friday
Shift(s): Days
Shift Length: 8 hours
Location: Remote*

Current List of non-MN States where Hennepin Healthcare is an Eligible Employer: Alabama, Arizona, Arkansas, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Mississippi, Nevada, North Carolina, North Dakota, New Mexico, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin.

Purpose of this position: Responsible for the management and strategic direction of the hospital billing coding area to ensure coding accuracy, timeliness and maximum equitable reimbursement from all carriers. Hospital billing coding should be completed and processed within the timeframes established by HCMC’s revenue cycle management as well as backlogs and rejections are minimized. Oversight will be required in the following functions: medical record documentation, archiving, coding accuracy audits, and reporting. Other Management responsibilities include: strategic planning, budget preparation and oversight; hiring, disciplining, and terminating employees; staff development to ensure that this area meets the service needs of the organization. Serves as a resource and assists with organizational compliance on HIPAA Privacy standards, and The Joint Commission standards. Ensures appropriate procedures and policies are created and revised as needed and provides direction to the organization regarding the implementation of these policies. Works collaboratively as a key participant in the oversight of Epic and 3M Coding Reimbursement system enhancements to ensure efficient and effective processes and workflows in the professional coding area.

RESPONSIBILITIES

• Responsible for the management and strategic direction of the hospital billing coding department, which includes, medical record documentation, archiving, chart audits, and reporting. This position has shared responsibility to achieve the business unit goals in targeted areas such as unbilled accounts receivable, compliance with regulatory requirements, coding and data accuracy and reimbursement from third-party payers. Management responsibilities include: strategic planning, budget preparation and oversight; hiring, disciplining, and terminating employees; staff development to ensure this department meets the service needs of the organization as follows:
  • Interview, hire, orient, review and discipline employees
  • Conduct employee performance evaluations and reviews, annual salary review, and performance documentation and discussion
  • Coordinate and prioritize work flow
  • Oversee the scheduled work hours; monitor staffing, time cards, overtime, vacations, and time off
  • Conduct appropriate departmental staff meetings
  • Ensure new employee training is completed and training for all employees is current and ongoing
  • Assist employees in solving problems as necessary
  • Monitor and recommend staffing levels
  • Monitor accuracy, efficiency and productivity of all coding personnel to ensure compliance with departmental performance standards
  • Develop and maintain budget for the hospital billing coding department
  • Works with staff to ensure compliance of, and proper coding procedures are adhered to as defined by CMS regulations, Local Medicare Carrier Review Policies (LMRP), Local Carrier Determinations (LCD), the AMA any applicable HCMC compliance policies, as well as any relevant accrediting and payer organizations
• Serves as a resource and assists with organizational compliance on coding policy and practices, HIPAA Privacy and interrelated Security standards, release of information standards and The Joint Commission standards that apply to the professional coding functions
• Ensures that coding and operational policies are created and revised as needed and provides direction to the organization regarding the implementation of these policies
• Serves as a resource for the organization on the assignment of codes which includes diagnoses and procedural codes, and must exhibit knowledge and expertise in ICD-9, ICD-10, CPT, and HCPCS
• Leads and is accountable for coding projects
• Works collaboratively as a key participant in the development and implementation of system enhancements and modifications of coding workflows
• Attends management meetings, interacts with HCMC management to resolve problems and acts as a liaison to the revenue cycle management team
• Assists Revenue Cycle Management with the development and implementation of administrative policies, procedures and guidelines for departmental operations. Responsible for periodic evaluation of operational processes to assess relevancy to changing goals and objectives of the department
• Maintains mutual respect and ensures mutual understanding with all HCMC personnel
• Proactively identifies and evaluates issues and identifies appropriate subject matter experts and other information resources to resolve problems
• Builds a cohesive team by establishing clear direction, goals and responsibilities. Supports the team’s success by providing necessary resources and breaking down barriers. Creates an environment which fosters motivation and builds commitment

QUALIFICATIONS
Minimum Qualifications:

• Bachelor degree in business and /or healthcare administration, Health Information Management or Health Information Technology
• Certified Professional Coder (CPC) certification or Certified Coding Specialist-Physician (CCS-P), Registered Health Information Administrator (RHIA) Registered Health Information Technologist (RHIT) in an active status with the American Health Information Association (AHIMA) preferred
• Three (3) years Healthcare management experience with supervisory/management responsibilities.
  -OR-
• An approved equivalent combination of education and experience.

Preferred Qualifications:

• Certificate of registration as a registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) preferred

Knowledge/ Skills/ Abilities:

• Epic Physician Billing Coding functionality
• Optum Claims Manager and Encoder 
• Knowledge of state and federal legislation for HIPAA Privacy, medical record access and release of information, and regulatory and accreditation agencies; retention of medical records; storage and retrieval systems, 
• Knowledge of current medical record technology, statistics, data presentation and reporting
• Skilled in the use of computer systems, including practice management systems, reporting tools and the Microsoft office suite; creating presentations, facilitation of meetings
• Develop and implement policies and procedures