Supervisor, Coding and Auditing

Thedacare • Neenah, WI

30d

About The Position

The Supervisor, Coding & Auditing oversees the day-to-day operations of the workflow and productivity for clinic health record coding. Ensures the quality of service by maintaining current knowledge of coding, quality initiatives, data collection, reporting, professional coding systems, and federal compliance requirements, and effectively communicating this information to department team members and other affected areas. Oversees the daily operations of the assigned area including administrative, fiscal, and clinical/technical activities to ensure high quality health care services. Develops developing department initiatives that focus on employee engagement, process improvement initiatives, patient satisfaction, and workplace safety. Serves as a resource and facilitates collaboration between team members and other healthcare disciplines throughout ThedaCare to ensure accurate and complete coding and statistical information. Ensures team members are in compliance with state and federal regulations and department/system policies, and that procedures are being followed. Promotes and strengthens employee engagement, process improvement initiatives, patient satisfaction, and workplace safety. Maintains and enhances interpersonal relationships with medical staff, team members, and patients.

Requirements

• High school diploma or GED
• Certified Professional Coder (CPC) or other equivalent credential
• Three years of leadership experience including leading work teams and/or projects
• Five years of coding experience
• Ability to move freely (standing, stooping, walking, bending, pushing, and pulling) and lift up to a maximum of twenty-five (25) pounds without assistance
• Job classification is not exposed to blood borne pathogens (blood or bodily fluids) while performing job duties
• Use of computers throughout the work day
• Frequent use of keyboard with repetitive motion of hands, wrists, and fingers
• Normally works in climate controlled office environment
• Frequent sitting with movement throughout office space

Responsibilities

• Is responsible for supervising the physician coding staff including orientation, training, performance development, competency assessment, and disciplinary actions.
• Educates the coding team members and other healthcare professionals in the use of coding guidelines, proper documentation techniques, and functions.
• Evaluates and determines integrity of coding controls and revenue generation is maintained at the highest possible level.
• Supervises the coding of patient encounters and conducts internal coding audits for accuracy. Is responsible for the timely completion of coding and data/charge entry required in the revenue cycle process.
• Establishes, implements, and maintains a formalized review process for coding compliance including a formal review (audit) process. Designs and uses audit tools to monitor the accuracy of clinical coding.
• Monitors Medicare and other payer bulletins and manuals, and reviews the current Office of the Inspector General (OIG) work plans for coding risks.
• Performs data quality reviews on outpatient encounters to validate the International Classification of Diseases (ICD-9-CM), the Current Procedural Terminology (CPT), and the Healthcare Common Procedure Coding System (HCPCS).
• Monitors medical visit code selection against facility specific criteria for appropriateness. Assists in the development of such criteria as needed.
• Identifies patterns, trends, and variations related to provider benchmarks and payer denials. Investigates and evaluates potential causes and takes appropriate steps in collaboration with team members to affect resolution or explain variances.

Benefits

• Lifestyle Engagement
• e.g. health coaches, relaxation rooms, health focused apps (Wonder, Ripple), mental health support
• Access & Affordability
• e.g. minimal or zero copays, team member cost sharing premiums, daycare

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees