General Summary: Responsibility for coordination of employees and processes in assigned areas of HIM Clinical Coding, and Coding Audit; OP Observation and I&I facility Coding. Performs quality and compliance audits. Reviews medical record documentation to determine coding accuracy.
Essential Duties:
1. Oversees variety of duties which can include: serves as an expert coding resource for HIM Management, service line coders, office staff and physicians. (Facility and Professional coding), review of denials and rejections including HIM work queues, complex coding issues, and quality initiatives.
2. Maintains expert coding knowledge (ICD-10-CM, CPT/HCPCS) and understanding of government regulations, third party payor requirements and various reimbursement methodologies (MS-DRG, APR-DRG, APC, Rehab CMG, RVU),
3. Coordination of staffs day to day operations, assists in trouble shooting issues, problem solving and resolution of customer service and/or billing issues. Identify problematic coding trends based on audit activity to provide ongoing training and education
4. Monitors goals & objectives for assigned area to assist in achieving turnaround times, staff productivity and quality.
5. Assists in interviews, training, counseling, audits, and evaluating performance of staff.
6. May compile statistics, weekly & monthly reports and employees schedules
7. Coordinates responses to payor audits for reconsideration process (appeal preparation)
8. Review and complete uncoded accounts in follow up and uncoded workques.
9. And other assigned duties.
Standard Qualifications
Bachelors or Associates Degree in Health Information Management or health related field.
Minimum of 4 years of hospital and/or professional coding experience.
RHIA, RHIT certification
Other Qualifications:
Excellent verbal and written communication skills for presentations and education sessions. Able to prioritize duties. Excellent organizational and time-management skills Ability to work independently and meet deadlines. Computer application skills (Windows, Microsoft Office), electronic health record and encoder applications.
