Outpatient Coding QA & Reimbursement Supervisor

Harris Health System

8d • Remote

About The Position

This role leads and supports outpatient coding and clinical documentation improvement by supervising audit and reimbursement teams, driving accuracy, and ensuring compliance with OPPS and CMS guidelines. The position develops performance scorecards, manages workflows for audits and denials, and delivers targeted education to enhance coding quality and reduce compliance risk. Acting as a key resource for coding queries and quality reporting, this role fosters collaboration across departments and promotes continuous professional development through CEU-eligible training initiatives.

Requirements

• Degrees: Bachelors: Health Information Management and/or equivalate (Preferred), Associates: Health Information Management
• Licenses & Certifications: Registered Health Information Administrator (RHIA) (Preferred), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Outpatient Coder (COC)
• Work Experience: Five (5) Years of Experience in Outpatient Coding and Training.
• Management Experience: Three (3) Years of Experience in Leadership, Supervisory, or Auditing.
• Communication Skills: Above Average Verbal Communication (Heavy Public Contact), Exceptional Verbal (Public Speaking), Writing/Correspondence, Writing/ Reports
• Knowledge/Skills/Abilities: Analytical Abilities, Design, Medical Terms, Research Knowledge and Abilities, Statistical Knowledge and Abilities
• Eligible for Telecommute
• Flexible
• Microsoft Suite: MS Word, MS PowerPoint, MS Excel, MS Outlook, MS Access, MS Project
• Detailed knowledge of coding conventions and rules established by the American Medical Association (AMA), the Center for Medicare and Medicaid Services (CMS), the ICD-10-CM Official Coding Guidelines, and AHIMA for assignment of diagnostic and procedural codes.
• Detailed knowledge of medical terminology, abbreviations, anatomy and physiology, major disease processes, and pharmacology.
• Detailed knowledge of classification systems of ICD-10 CM and PCS nomenclature, coding rules, guidelines, and proper sequencing.
• Knowledge of JCAHO, Privacy Act of 1974, and HIPAA standards affecting medical records and their impact on reimbursement.
• Knowledge of ethical coding principles and revenue cycle activities.
• Skill in interpreting and applying ethical coding standards, understanding federal and state laws and regulations, and following professional practice standards for health care organization coding compliance program activities.
• Detailed knowledge of Clinical Documentation Improvement practices from Association of Clinical Documentation Integrity Specialists (ACDIS).
• Proficient in compliant query practices.
• Detailed comprehension of AHRQ quality indicators and manual guidelines along with qualifying inclusionary and exclusionary conditions.
• Equipment Operated: Regular office equipment and 3M 360 encoder interfaced with EPIC electronic medical record billing system

Nice To Haves

• Degrees: Bachelors: Health Information Management and/or equivalate (Preferred)
• Licenses & Certifications: Registered Health Information Administrator (RHIA) (Preferred)

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees