ProFee Coding Manager, Audits & Education - Remote based in US
About The Position
Strategically, the position is responsible for protecting the company's interests and advance business objectives with respect to HIM coding by helping to assure Tenet coders, providers, and vendors achieve accurate coding and charging. Tactically, the position is responsible for managing a team of individuals that conducts coding quality reviews of Tenet TPR coded accounts, identifying education opportunities based on those reviews and developing and delivering educational content. This position is responsible for supervising, scheduling and assessing the performance of the growing team of coding auditor/educator FTEs domestically and in the GBC. This position coordinates and monitors Coding Manager meetings, assignments and other activities as assigned by the Senior Director of Coding and CDI. This is a remote based role requiring travel up to 50%. The selected candidate will be required to pass a Motor Vehicle Record check.
Requirements
- Seven years progressive coding or coding review experience in a profee setting.
- Associate’s degree in health information management or related field
- Previous managerial/supervisory experience, such as a profee coding supervisor
- Certified in coding from AAPC or AHIMA
- Knowledge of applicable federal regulations (APC/OPPS, NCCI, ICD-10-CM Official Guidelines, OPPS, Coding Clinic, etc.)
- Proven ability to effectively communicate findings and deliver educational content to all levels of the organization
- Ability to balance multiple deadlines
Nice To Haves
- A bachelor's degree or higher in a health-related discipline
Responsibilities
- Annual Pro-Fee QA audit of assigned Providers (E&M, CPT, ICD10, Modifiers)
- Annual Pro-Fee QA audit of assigned TPR GBC or Vendor coders
- Pre-Bill Clearance for all new assigned providers
- Focused QA audits as assigned, i.e., OIG workplan, payor review notifications
- Provider/coder/practice coding education based on audit findings and trending of results
- Claim denial root cause analysis for assigned providers/coders and development / delivery of education for prevention of denials to appropriate entity
- Coding education resource for providers, coders, practice and staff queries
- Excellent communication and presentation skills both in person and via online platforms (1:1 or group settings)
Benefits
- Medical, dental, vision, disability, life, AD&D and business travel insurance
- Paid time off (vacation & sick leave)
- Discretionary 401k with up to 6% employer match
- 10 paid holidays per year
- Health savings accounts, healthcare & dependent flexible spending accounts
- Employee Assistance program, Employee discount program
- Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance.
- For Colorado employees, paid leave in accordance with Colorado’s Healthy Families and Workplaces Act is available.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
Associate degree
