Manager Physician Coding

Brown University Health•Providence, RI

50d•Onsite

About The Position

SUMMARY: Reporting to the Director, in the development and implementation of short and long-term goals of Brown University Health's mission, it's values and key business objectives. Provides sponsorship to the function by identifying resources required to achieve the operating results and advocates for them during resource allocation. Plans, directs and implements administrative and business activities of department. The Manager of Physician Coding provides direction and management to staff responsible for accurately coding medical records, auditing charts and resolving work queue edits, EDI errors and payer denials associated with coding related issues. Collaborates with the overall physician revenue cycle department to meet the metrics, mission, vision and values of the Brown University Health organization. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect and Excellence, as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate In addition, our leaders will demonstrate an aptitude for: Ensure Accountability and Build Effective Teams Drive Vision and Purpose and Optimize Work Processes By applying core and leadership competencies, leaders help Brown University Health achieve its strategic goals. RESPONSIBILITIES: Provides input into the development of the capital and operating budgets for the academic medical center's abstracting and coding activities; monitors same, investigates and resolves variances. Directs the effective utilization of resources (people, financial, material and equipment), to meet established goals and objectives of Brown University Health's agreed upon operating priorities to ensure activities support the system's strategies, while maintaining fiscal responsibility. Plans, coordinates, prospectively assists in the development and management of annual budgets: margin-left:.25in;text-indent:-.25in;mso-list:l0 level1 lfo1; tab-stops:list .25in!--[if !supportLists]--A. font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: times= new= roman;= Arranges for timely completion and submission of operating budget worksheets based on projected changes to rates, volume and/or patient mix, historical and trend analyses of clinical productivity, payroll and non-payroll expenses, including equipment acquisition analyses and the like. margin-left:.25in;text-indent:-.25in;mso-list:l0 level1 lfo1; tab-stops:list .25in!--[if !supportLists]--B. font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: times= new= roman;= Confers with and advises Senior Management to obtain agreement on changes to budget requests and allocations and their impact on department financial objectives. margin-left:.25in;text-indent:-.25in;mso-list:l0 level1 lfo1; tab-stops:list .25in!--[if !supportLists]--C. font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: times= new= roman;= Regularly monitors and prepares monthly reports of actual FTE budgeted performance, including written explanations of variances and recommended corrective actions. Develops recording and control systems for personnel actions and purchase requisitions, initialing and/or approving same as needed within established guidelines. In conjunction with Senior Management, as appropriate: margin-left:.5in margin-left:.5inHires, coaches and motivates team; determines appropriate and effective performance metrics and staff requirements for the department to run with efficiency, accuracy and outstanding customer service. Implements and monitors staff productivity and service performance metrics. Oversees and manages the daily performance of reporting staff. margin-left:.5in margin-left:.5inEffects consistent application of personnel policies and employee relations' activities as they pertain to staff. Consult with personnel representatives as needed to facilitate optimum results. Develops and implements department's administrative support policies and procedures. margin-left:.5in Assists with development of all the department's priorities, procedures and policies for Brown University Health. Develops processes and procedures for the efficient and successful flow of interdependent information between the individual practices and the coding team. Designs and executes key strategies to drive the revenue cycle. Develops a schedule of internal audits and audit processes that will assess individual coders' adherence to coding guideline, provide feedback to each coder and measure everyone's progress. Identifies the need for education and feedback to practice providers and staff and helps develop processes and educational materials. Works with Corporate Compliance and payers to execute external audits as needed. Stays abreast of changes to coding guidelines, educate coders and auditors on these changes and update other members of the team as appropriate. Researches complex coding issues, finds solutions and updates the staff and practices as needed. Monitors coding compliance with all third party payer regulations. Ensures practice satisfaction is achieved through courteous and effective communication, problem solving, implementation of efficient processes and timely follow-through. Promotes a team-oriented environment that fosters effective collaboration within and outside of the department. Assists physician group in establishment of policies relating to documentation and coding. Assists in design, implementation and optimization of physician billing system, making recommendations for changes as necessary. Plays a significant role in long-term planning, including initiatives geared toward operational excellence. Improves the operational systems, processes and policies in support of organizations mission -- specifically, support better management reporting, information flow and management, business process and organizational planning. Manages and increases the effectiveness and efficiency of Shared/Support Services through improvements to each function as well as coordination and communication between support and business functions. Maximizes reimbursement, meeting established clean claim rates, timely resolution of payer suspended and/or rejected claims as well as assuring the most appropriate documentation and coding per treatment performed. Serves as a resource to staff members on all billing and coding issues and responds to physician and patient inquiries as necessary. In conjunction with the Manager of Physician Billing, maintains appropriate inventory of all supplies, and assures that all instruments and equipment are in good working order. Performs other duties as assigned. MINIMUM QUALIFICATIONS: BASIC KNOWLEDGE: Associate's Degree in Business, Medical Billing or equivalent experience. Bachelor's degree or equivalent work experience with demonstrated results. Coding Certification in procedural coding required from American Academy of Professional Coding or the American Health Information Management Association. EXPERIENCE: p margin:0inMinimum of 5 years related experience and/or training, and 2 years related management experience, with experience within a large integrated healthcare delivery system preferred. p margin:0in p margin:0inEpic experience highly desired. p margin:0inBroad knowledge in business administration, finance and healthcare administration. Thorough knowledge of third party commercial and governmental billing. p margin:0in High level of organizational and interpersonal skills to interact with Senior Management on matters having multiple and varying impact on department financial objectives and to respond effectively to competing needs for resources. Managerial skills to develop and supervise department support staff. WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS: Work is performed in a typical office environment requiring extended periods of sitting, standing and walking. INDEPENDENT ACTION: Incumbent acts independently and in accordance with policies and procedures, referring unusual problems to the Director. SUPERVISORY RESPONSIBILITY: Supervises up to 50 FTEs telecommuting and non-telecommuting employees.

Requirements

Associate's Degree in Business, Medical Billing or equivalent experience.
Bachelor's degree or equivalent work experience with demonstrated results.
Coding Certification in procedural coding required from American Academy of Professional Coding or the American Health Information Management Association.
Minimum of 5 years related experience and/or training, and 2 years related management experience, with experience within a large integrated healthcare delivery system preferred.
Broad knowledge in business administration, finance and healthcare administration.
Thorough knowledge of third party commercial and governmental billing.
High level of organizational and interpersonal skills to interact with Senior Management on matters having multiple and varying impact on department financial objectives and to respond effectively to competing needs for resources.
Managerial skills to develop and supervise department support staff.

Nice To Haves

Epic experience highly desired.

Responsibilities

Provides input into the development of the capital and operating budgets for the academic medical center's abstracting and coding activities; monitors same, investigates and resolves variances.
Directs the effective utilization of resources (people, financial, material and equipment), to meet established goals and objectives of Brown University Health's agreed upon operating priorities to ensure activities support the system's strategies, while maintaining fiscal responsibility.
Plans, coordinates, prospectively assists in the development and management of annual budgets:
Arranges for timely completion and submission of operating budget worksheets based on projected changes to rates, volume and/or patient mix, historical and trend analyses of clinical productivity, payroll and non-payroll expenses, including equipment acquisition analyses and the like.
Confers with and advises Senior Management to obtain agreement on changes to budget requests and allocations and their impact on department financial objectives.
Regularly monitors and prepares monthly reports of actual FTE budgeted performance, including written explanations of variances and recommended corrective actions.
Develops recording and control systems for personnel actions and purchase requisitions, initialing and/or approving same as needed within established guidelines.
Hires, coaches and motivates team; determines appropriate and effective performance metrics and staff requirements for the department to run with efficiency, accuracy and outstanding customer service.
Implements and monitors staff productivity and service performance metrics.
Oversees and manages the daily performance of reporting staff.
Effects consistent application of personnel policies and employee relations' activities as they pertain to staff. Consult with personnel representatives as needed to facilitate optimum results.
Develops and implements department's administrative support policies and procedures.
Assists with development of all the department's priorities, procedures and policies for Brown University Health.
Develops processes and procedures for the efficient and successful flow of interdependent information between the individual practices and the coding team.
Designs and executes key strategies to drive the revenue cycle.
Develops a schedule of internal audits and audit processes that will assess individual coders' adherence to coding guideline, provide feedback to each coder and measure everyone's progress.
Identifies the need for education and feedback to practice providers and staff and helps develop processes and educational materials.
Works with Corporate Compliance and payers to execute external audits as needed.
Stays abreast of changes to coding guidelines, educate coders and auditors on these changes and update other members of the team as appropriate.
Researches complex coding issues, finds solutions and updates the staff and practices as needed.
Monitors coding compliance with all third party payer regulations.
Ensures practice satisfaction is achieved through courteous and effective communication, problem solving, implementation of efficient processes and timely follow-through.
Promotes a team-oriented environment that fosters effective collaboration within and outside of the department.
Assists physician group in establishment of policies relating to documentation and coding.
Assists in design, implementation and optimization of physician billing system, making recommendations for changes as necessary.
Plays a significant role in long-term planning, including initiatives geared toward operational excellence.
Improves the operational systems, processes and policies in support of organizations mission -- specifically, support better management reporting, information flow and management, business process and organizational planning.
Manages and increases the effectiveness and efficiency of Shared/Support Services through improvements to each function as well as coordination and communication between support and business functions.
Maximizes reimbursement, meeting established clean claim rates, timely resolution of payer suspended and/or rejected claims as well as assuring the most appropriate documentation and coding per treatment performed.
Serves as a resource to staff members on all billing and coding issues and responds to physician and patient inquiries as necessary.
In conjunction with the Manager of Physician Billing, maintains appropriate inventory of all supplies, and assures that all instruments and equipment are in good working order.
Performs other duties as assigned.