HIS - Professional Coding Integrity Supervisor

Blanchard Valley Health System • Findlay, OH

71d

About The Position

The primary purpose of the Professional Coding Integrity Supervisor is to maintain the daily operations of the Professional Coding Integrity Specialists (PCIS), provide education to providers, offices, and other departments to ensure accurate, compliant and optimal professional charge capture which is supported by clinical documentation. Coordinate with the Professional Coding Integrity Auditor/Educator to research coding questions from offices, departments, and providers. Supports the PCIS job functions as necessary. Provides general coding support as well as education and training for new and existing BVHS providers.

Requirements

• An Associate’s Degree in a related field including, but not limited to, Health Information Management or 2+ years’ experience from which comparable knowledge and abilities have been acquired.
• Coding certification (CPC or CCS-P) required or obtained with 9 months of hire date.
• CDEO (Certified Documentation Expert Outpatient) certification required or achieved within 9 months or CPMA (Certified Professional Medical Auditor) certification required or achieved within 9 months.
• Knowledge of medical terminology, anatomy and physiology required.
• Knowledge of CPT/HCPCS coding systems, appropriate use of applying modifiers, CPT Assistant, LCD/NCD and ICD-10 diagnosis coding concepts required.
• Training, research, and education skills required.
• Ability to present data/information in an organized and meaningful way; must be comfortable with public speaking as well as education/training of both small & large groups.
• Ability to research, review and interpret Federal, State and Local billing regulations required.
• Familiarity with utilization of computers and commonly used applications, including Microsoft Office Suite, electronic health record, internet required.
• Ability to track and monitor data to identify trends pertaining to charge issues.
• Excellent organizational, time management and problem-solving skills required; detail oriented and follow through.
• Positive service-oriented interpersonal and communication (written and verbal) skills required.
• A valid driver's license is required.

Nice To Haves

• Specialty specific certification(s)
• Knowledge of regulatory compliance and reimbursement methodologies
• Encoder experience

Responsibilities

• Provide direct oversight of the PCIS team and related functions with the primary objective to support the integrity of the professional charge processes by ensuring capture of all revenue opportunities and compliance with applicable regulatory standards.
• Perform supervisory administrative support functions including but not limited to: assist in the recruiting and hiring process, training and education of associates, coordinate staff schedules, payroll, completion of associate performance evaluations, recognition and reward, disciplinary follow up as appropriate.
• Identify clinical documentation opportunities and provide routine feedback and education to medical staff providers to support compliant, accurate and optimal charge capture.
• Remain current on regulatory guidelines related to CPT and ICD-10 coding updates.
• Review quarterly internal quality audits of the PCIS team, in coordination with the auditor/educator.
• Work with the Compliance Department to assist in response to investigational or potential compliance risks.
• Work with Coding Claims Resolution Specialist (CCRS) to review denial trends and prepare feedback for improvement opportunities.
• Monitor PCIS work queues and reassign encounters as needed to maintain a manageable level of encounters.
• Demonstrate superior knowledge of federal, state and third-party charging guidelines of clinical areas supported by the Professional Coding Integrity team.
• Participate in system testing as a result of upgrades, changes, enhancements, new application implementations.
• Regularly attend and actively participate in in-services, organizational and department meetings and continuing education programs.

What This Job Offers

• Job Type: Full-time
• Education Level: Associate degree
• Number of Employees: 1,001-5,000 employees