Supervisor, CBO Coding & Billing

Phoebe Putney Health System•Albany, GA

About The Position

The PPG Coding/Billing Supervisor maintains an efficient and timely coding and billing process while ensuring the accuracy and quality of coded, abstracted information and billed services for all patient types across all hospital campuses, and Phoebe Provider Group. The supervisor will coordinate the day-to-day operations of the PPG Coding team to ensure all coding functions are performed timely and according to published coding guidelines and as directed by state and federal regulations. Supervise all PPG CBO Coding staff. Develop and maintain practices to perpetuate quality and consistency among coding staff. Act as a liaison for the Compliance department in matters of coding assurance as appropriate. Provides ongoing education to coders under their leadership. The Coding and Billing Supervisor reports to the Coding and Billing Manager.

Requirements

Associates Degree's in Healthcare, Business, Finance, Information Systems, or a related field or High School Diploma or GED and addition 4 years of related revenue cycle experience (Required)
3 or years of experience in health information management or coding management in a hospital or physician practice/clinic setting, financial operations, and information systems experience preferably within the Revenue Cycle functional area in the Healthcare Industry. (Required)
Registered Health Information Administrator (RHIA)
Registered Health Information Technician (RHIT)
Certified Coding Specialist (CCS)
Certified Coding Specialist – Physician (CCS-P) or Certified Professional Coder (CPC)

Nice To Haves

3 or more years of related revenue cycle healthcare experience, preferably within coding and billing. (Preferred)
Prior Athena or Meditech experience. (Preferred)
Experience with any of Phoebe Provider Groups legacy financial systems (Preferred)
2 years of experience in health information management or coding management in a hospital or physician practice/clinic setting (Preferred)

Responsibilities

Review medical records to assign ICD-10CM, CPT, and HCPCS Level II codes and modifiers in a thorough and accurate manner.
Manages the daily operations of the PPG Coding Department to promote steady workflow and data integrity.
Research coding questions and provide coder feedback.
Ensures timely correction of coding errors and edits.
Ensures coding audits are performed concurrently and that the areas being audited are updated in conjunction with the department policies.
Monitors the aging and DNB accounts to ensure that accounts are coded in a timely manner and that performance is within established coding quality and productivity benchmarks.
Conducts regular audits and coordinates monitoring of coding accuracy, productivity, and available clinical documentation.
Ensures that audit reports are reviewed, and accurate, and corrective action plans implemented.
This position is responsible for directing and coordinating the overall functions of the billing and coding office to ensure maximization of cash flow while improving patient, physician, and other customer relations.
The Medical Billing Manager position requires the ability to produce and present detailed billing activity reports.
Supervises the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management.
Serves as the practice expert and go-to person for all coding and billing processes.
Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection.
Analyze billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues.
Follow up on claims using various systems, i.e., practice management and clearinghouse.
Provides feedback and assists in facilitating and/or coordinating focused educational programs regarding coding and clinical documentation best practices to Coding and clinical staff as needed.
Interviews, hires and trains employees; plans, assigns and direct workflow, appraises employee performance; addresses complaints and resolving problems; and proactively manages production and quality control efforts.
Conducts trend analysis to identify patterns and variations in coding/documentation practices and case mix index.
Identifies process improvement opportunities within the Coding department and implements solutions.
Reviews claim denials and rejections pertaining to coding and medical necessity issues and implements corrective action plans as needed/required.
Works with Coding Leads to provide all Coding staff with annual, quarterly, semi-annual ICD-10-CM/PCS and/or CPT code changes and coordinates with Information Systems & Technology to ensure timely system updates.
Maintains all coding information and provides updated manuals, resources, and other coding material.
Actively participates in the Internal Audit Process exit conferences, providing clarification and supporting information necessary.
Collaborates with other coding managers outside of the organization to ensure consistent implementation of coding policies, procedures, and practice.
Maintain strong communication with Director(s) and business partners in reporting unbilled activities related to coding.
Mentors team members to encourage personal and professional growth.
Encourages ongoing skill development by providing opportunities for continued education.
Applies critical thinking, problem-solving, and change management skills to lead the process and team in identifying and resolving systemic issues.
Work with the Training and Education department to develop and deploy training for new employees and provide ongoing training as needed.
Complete annual performance reviews for employees and provide timely feedback to employees and address performance/quality and training issues as appropriate.
Develop and revise department policies and procedures as required.
Deliver a positive patient experience.
Liaise appropriately with peers across the system.
Complete disciplinary action as required.
Adhere to Phoebe Provider Group organizational policies and procedures for relevant location and job scope.
Perform any special assignments as requested.
Work with the Training and Education department to develop and deploy training for new employees and provide ongoing training as needed.
Monitors, verifies, and reconciles expenditures of budgeted funds, compiles information reflecting expenditures, and develops cost- comparisons.
Identify cost savings within the operation.
Adheres to the hospital and departmental attendance and punctuality guidelines.
Performs all job responsibilities in alignment with the core values, mission and vision of the organization.
Performs other duties as required and completes all job functions as per departmental policies and procedures.
Maintains current knowledge in present areas of responsibility (i.e., self education, attends ongoing educational programs).
Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time.
Demonstrates competency at all levels in providing care to all patients based on age, sex, weight, and demonstrated needs.
For non-clinical areas, has attended training and demonstrates usage of age- specific customer service skills.
Wears protective clothing and equipment as appropriate.