Supervisor, Coding & Auditing

ThedaCare • Neenah, WI

2d • Remote

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

Responsibilities

• Supervising the physician coding staff including orientation, training, performance development, competency assessment, and disciplinary actions.
• Educating the coding team members and other healthcare professionals in the use of coding guidelines, proper documentation techniques, and functions.
• Evaluating and determining integrity of coding controls and revenue generation is maintained at the highest possible level.
• Supervising the coding of patient encounters and conducting internal coding audits for accuracy.
• Responsible for the timely completion of coding and data/charge entry required in the revenue cycle process.
• Establishing, implementing, and maintaining a formalized review process for coding compliance including a formal review (audit) process.
• Designing and using audit tools to monitor the accuracy of clinical coding.
• Monitoring Medicare and other payer bulletins and manuals, and reviewing the current Office of the Inspector General (OIG) work plans for coding risks.
• Performing 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).
• Monitoring medical visit code selection against facility specific criteria for appropriateness.
• Assisting in the development of such criteria as needed.
• Identifying patterns, trends, and variations related to provider benchmarks and payer denials.
• Investigating and evaluating potential causes and taking 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