Network Facility Coding Manager

St. Luke's University Health Network•Allentown, PA

About The Position

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. PHYSICIAL AND SENSORY REQUIREMENTS: Sitting for up to 7 hours per day, 3 hours at a time. Repetitive arm/finger use for retrieving/viewing computerized patient medical record and abstracting of patient information. Extended periods of vision use for reviewing computerized patient record, abstracting of patient information, approximately 7 hours per day, 3 hours at a time. Hearing as it relates to normal conversation. Seeing as it relates to general vision, near vision, peripheral vision and visual monotony. Occasionally may be required to use upper extremities to lift up to 10 lbs; stoop, bend, or reach to retrieve resource materials and/or paper records in accordance with downtime policy; or use of wheel cart to and from Medical Record Department. POTENTIAL ON-THE-JOB RISKS: None identified SPECIFIC PROTECTIVE EQUIPMENT AVAILABLE: N/A MOST COMPLEX DUTY: Objectively applies understanding of ICD-9-CM/ICD-10-CM/PCS and CPT-4 coding guidelines to assure accurate and appropriate reimbursement. Supports/facilitates understanding of computerized Hospital database system, computerized patient record, and 3M Encoder. Manages/supervises CDCI professionals and daily coding activities. Collaborates and communicates effectively and tactfully with the Medical Staff and CDCI professionals. SUPERVISION (RECEIVED BY AND/OR GIVEN TO): Responsible for the management/supervision of CDCI professionals and volunteer staff. Reports to the Network Director, CDCI. COMMUNICATIONS: Must communicate frequently in an effective, tactful and diplomatic manner to CDCI professionals, Medical staff, Administration and other internal and external customers. ADDITIONAL REQUIREMENTS: Expected to maintain designated CEUs for AHIMA credentials (RHIA, RHIT, and/or CCS) in accordance with the AHIMA Governing Body, with confirmation of valid credentials for every two-year cycle reporting. Adherence to the confidentiality guidelines as outlined within the Hospital and departmental policies. Promote positive customer satisfaction by way of prompt and courteous customer service. QUALIFICATIONS (MINIMUM) EDUCATION: Graduate of an AHIMA-accredited Health Information Administration (RHIA) program or Health Information Technology (RHIT) program with Certified Coding Specialist credentials (CCS) required. Candidates with a health-care related degree and one of the AHIMA credentials (RHIA, RHIT, or CCS) may be considered. TRAINING AND EXPERIENCE: Minimum 5-7 years management experience in acute care, teaching hospital with strong inpatient and outpatient ICD-10-CM/PCS and CPT-4 coding experience and MS-DRG/APR-DRG assignment. Demonstrated experience in organizational, effective communication, time-management, and computer skills. Approved AHIMA ICD-10-CM/PCS Trainer preferred. WORK SCHEDULE: Day shift with varying hours based on the needs of the department. JOB SUMMARY Under general supervision of the sr. network director of CDCI, oversees and monitors coding operations including but not limited to providing guidance to the supervisors of IP and OP coding and coding appeals, DNB/CFB/CBO management, coordination of the annual external coding audits with feedback (individually & collectively) and establishing education sessions to ensure coding quality and consistency across the network; provides guidance with the coordination of daily workflow for all inpatient and outpatient coding professionals when needed and acts as the back-up to the Sr. Network Director, CDCI. Provides and/or assists with the training of new coding professionals. Maintains current knowledge of ICD-10-CM/PCS, CPT-4, MS-DRG and APR-DRG coding principles and conventions. Updates and maintains AHA coding clinic and department coding resources on a regular basis. Provides assistance to the business office, finance, registration and other departments as needed. The intent of this job description is to provide a summary of the major duties and responsibilities of this position and shall not be considered as a detailed description of all the work requirements that may be inherent in the position. The Network manager is responsible for the day-to-day operational performance of the inpatient and outpatient coding services across the network, ensuring accuracy, timeliness, compliance, and consistency in accordance with departmental and organizational standards

Requirements

Graduate of an AHIMA-accredited Health Information Administration (RHIA) program or Health Information Technology (RHIT) program with Certified Coding Specialist credentials (CCS) required.
Candidates with a health-care related degree and one of the AHIMA credentials (RHIA, RHIT, or CCS) may be considered.
Minimum 5-7 years management experience in acute care, teaching hospital with strong inpatient and outpatient ICD-10-CM/PCS and CPT-4 coding experience and MS-DRG/APR-DRG assignment.
Demonstrated experience in organizational, effective communication, time-management, and computer skills.
Expected to maintain designated CEUs for AHIMA credentials (RHIA, RHIT, and/or CCS) in accordance with the AHIMA Governing Body, with confirmation of valid credentials for every two-year cycle reporting.
Adherence to the confidentiality guidelines as outlined within the Hospital and departmental policies.
Promote positive customer satisfaction by way of prompt and courteous customer service.

Nice To Haves

Approved AHIMA ICD-10-CM/PCS Trainer preferred.

Responsibilities

Oversees internal and external coding audits, including coordination, response management, education follow-up, and monitoring of corrective actions.
Ensures coding practices align with ICD-10-CM/PCS, CPT/HCPCS, MS-DRG/APR-DRG guidelines and applicable regulatory requirements.
Collaborates with Quality and Clinical Documentation teams on medical record quality and documentation integrity initiatives as assigned.
Oversees development and delivery of coding education in collaboration with education/audit coordinators.
Ensures policies, procedures, and reference materials are current and consistently applied.
Identifies operational improvement opportunities and supports implementation of approved process changes.
Manages assigned staff, including scheduling, performance evaluations, coaching, and disciplinary actions in accordance with HR policies.
Participates in hiring, onboarding, and orientation of coding staff and coordinators.
Serves as an escalation point for operational questions from lead coders and coordinators.
Partners with Finance, HIM, Admissions, CDI, and other departments to resolve coding-related operational issues.
Represents coding operations in meetings as assigned and ensures follow-through on action items.
Performs additional duties as assigned to support departmental operations