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Manager Outpatient Coding (Remote Candidates Considered)

Company: Cape Cod Healthcare Inc.
Location: Plymouth
Posted on: November 20, 2022

Job Description:

  • Ensure compliant quality coding and abstraction of clinical data.
  • Manage CCHC staff and vendors performing outpatient coding and facilitates problem resolution of coding issues.
  • Confirm supervisory staff are consistently performing performance-monitoring processes.
  • Define, implement, and monitor strategies for improving documentation.
  • Develop physician education strategies in conjunction with Clinical Documentation Improvement to promote complete and accurate clinical documentation.
  • Develop and report performance measures to the medical staff and other departments of physician specific information regarding documentation compliance.
  • Collaborate extensively with physicians, nursing staff and other patient caregivers to improve quality and completeness of documentation of care provided and coded.
  • Manage concurrent modifications to clinical documentation to ensure commensurate reimbursement of clinical severity and services rendered to patients
  • Work with the business office to facilitate resolution of coding/billing issues.
  • Develop and administer Quality Improvement ("QI") and compliance initiatives.
  • Monitor discharged not final billed daily accounts receivable and accounts ("DNFB") and any other metrics/benchmarks established by the department.
  • Collaborate with other disciplines regarding proposed coding changes and changes needed to address quality concerns and communicate with the medical staff leadership.
  • Coordinate external audits and third party reviews. Conduct exit interviews and implement appeal processes as required.
  • Ensure staff address failed claim errors to billing edits, clinical trial codes, and other coding related errors.
  • Audit coding and medical record documentation systematically in accordance to National Correct Coding Initiative ("NCCI") and departmental policies and create and administer policies and procedures to enhance compliance.
  • Maintain up-to-date knowledge of regulatory and compliance changes impacting coding requirements and operations, and ensure coding employees are appropriately educated and processes are modified as needed.
  • Manage to applicable coding Key Performance Indicators ("KPIs"). Define and implement action plans when performance is not meeting expectations.
  • Assess direct reports' performance on a consistent basis and provide feedback to reward effective performance and enable proactive performance improvement steps to be taken
  • Ensure outpatient coding employees and vendor staff are performing coding functions in a manner that complies with established policies, processes and quality assurance programs.
  • Support IT in their efforts to test modifications and troubleshoot issues for the Coding Encoder, Patient Financial Services Application, EMRs and other applicable systems.
  • Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers.
  • Perform other work-related duties as assigned or requested.
  • Challenges current working practices; identifies process improvement opportunities and presents recommendations and solutions to management. Engages and commits to the organization's culture of continuous improvement by actively participating, supporting, and promoting CCHC Pillars of Excellence
  • Bachelor's degree required or equivalent combination of education and experience. Master's degree preferred.
  • Current CCS (AHIMA Certified Coding Specialist) or CPC (AAPC Certified Professional Coder) required.
  • Minimum of five years of previous experience in Outpatient Medical Record coding for reimbursement with strong working knowledge of medical terminology, anatomy and physiology, reimbursement groupers such as DRGs and APCs as well as third party reimbursement requirements.
  • Strong knowledge of fiscal intermediary and regulatory agency regulations for coding and hospital reimbursement.
  • One to two years supervisory experience of inpatient and/or outpatient coding staff.
  • Required three to five years of demonstrated experience with health information systems, encoder and EMRs across the revenue cycle discipline..
  • An understanding of the psychology of complex corporate relationships, and an ability to influence within such an environment.
  • Excellent communication, leadership, delegation, and interpersonal skills.
  • Ability to evaluate personal performance against established goals.
  • Demonstrated goal-oriented thinking, operational and organizational skills.
  • Ability to communicate with and present to a wide variety of CCHC and external users, including senior management and physicians, as well as outside vendors and consultants.
  • Ability to work under pressure and manage multiple initiatives concurrently; must be able to work independently, set own priorities and meet deadlines.

Keywords: Cape Cod Healthcare Inc., Plymouth , Manager Outpatient Coding (Remote Candidates Considered), Executive , Plymouth, Massachusetts

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