Documentation and Coding Manager

UCSF • San Francisco, CA

10d

About The Position

The Documentation and Coding Manager oversees the Department of Emergency Medicine’s documentation integrity responsibilities in conjunction with the UCSF Health Faculty Practice Revenue Management Organization and the Clinical Practice Group at Zuckerberg San Francisco General Hospital, and provides analytical support to the department’s leadership team. The role leads projects and/or team members, proposes programs and policies consistent with best practices, and manages projects of varying complexity and scope. It requires independent judgment, strong organization and prioritization, advanced technical skills, professionalism, diplomacy, and the ability to work effectively with little or no supervision. The incumbent manages project-based problem-solving from information gathering and analysis through recommendations or completed deliverables, anticipates issues and stakeholder needs, and initiates solutions independently.

The position supports professional-fee coding operations, documentation quality and compliance, and revenue-cycle strategy and optimization. It works with clinical, technical, administrative, and financial leaders to improve workflows, maintain accurate and compliant physician documentation, analyze complex financial and operational data, develop reports and recommendations, and improve revenue-cycle efficiency and reimbursement. The role also monitors regulatory and payer changes and implements appropriate changes to systems, policies, and procedures.

Requirements

• Minimum 5 years of related experience.
• In-depth knowledge of healthcare revenue-cycle practices, procedures, and concepts, including billing, collections, charge capture, contractual adjustments, third-party reimbursements, and cash management.
• In-depth understanding of revenue-cycle measurement and analysis, including relevant issues, processes, reporting instruments, metrics, dashboard design, tools, and techniques.
• Advanced organizational and project-management skills, including the ability to lead a team, prioritize tasks, and complete projects on schedule from inception to completion.
• Advanced skills in report development, dashboard design, healthcare revenue-cycle software tools, and common database, spreadsheet, and presentation software.
• Advanced communication skills, including the ability to explain complex clinical-finance information clearly and prepare reports and presentations for all levels of staff and management.
• Advanced analytical and problem-solving skills to evaluate revenue-cycle workflows and systems, identify weaknesses, and develop solutions and process improvements.
• Advanced interpersonal skills and the ability to collaborate on highly complex projects with diverse business and clinical areas.
• Ability to advise management as a technical expert and provide improvement proposals and guidance on regulatory changes and industry trends and developments in revenue-cycle management.
• Bachelor’s degree in a related area and/or equivalent experience or training.
• Certified Professional Coder (CPC).

Nice To Haves

• Master’s degree in a related area and/or equivalent experience or training.

Responsibilities

• Participate in establishing quality standards, expectations, and benchmarks for billing and collections documentation, using departmental input, operational experience, and best-practice research.
• Collaborate with clinical, technical, administrative, and financial leaders to develop or improve documentation workflows across departments in support of revenue management.
• Oversee review of physician documentation at Department of Emergency Medicine sites, identify non-compliant charts, and communicate with physicians to support timely completion and accurate, compliant documentation of care delivered.
• Manage compliance activities, including education and training for faculty and staff, and keep current on University Compliance Office guidelines, CMS rules and regulations, and insurance payer policies and requirements.
• Perform chart-review audits at Department of Emergency Medicine sites as needed and propose remediation and improvement plans and strategies.
• Analyze highly complex financial data and identify revenue-cycle trends; deliver reports and presentations to leadership, including proposals and solutions to maximize revenue.
• Lead and/or monitor project progress and priorities; collaborate across departments to define needs, goals, metrics, system requirements, and capabilities.
• Evaluate revenue-cycle workflows as a technical leader and resource, recommend efficiency and timeliness improvements, and guide development of complex workflow improvements across revenue-cycle areas.
• Recommend and implement processes and systems to improve charge integrity, reconciliation, and charge linkages from ancillary charging systems.
• Develop and implement changes to systems, policies, and procedures to maintain currency with government regulations, reimbursement issues, and other matters with potential financial impact.
• Monitor changes in government regulations and third-party carrier requirements and communicate trends, best practices, and internal or external compliance issues.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager