Supervisor Coding Integrity & Denials

Lehigh Valley Health Network•Bethlehem, PA

18h•Onsite

About The Position

Imagine a career at one of the nation's most advanced health networks. Be part of an exceptional health care experience. Join the inspired, passionate team at Lehigh Valley Health Network, a nationally recognized, forward-thinking organization offering plenty of opportunity to do great work. LVHN has been ranked among the "Best Hospitals" by U.S. News & World Report for 23 consecutive years. We're a Magnet(tm) Hospital, having been honored five times with the American Nurses Credentialing Center's prestigious distinction for nursing excellence and quality patient outcomes in our Lehigh Valley region. Finally, Lehigh Valley Hospital - Cedar Crest, Lehigh Valley Hospital - Muhlenberg, Lehigh Valley Hospital- Hazleton, and Lehigh Valley Hospital - Pocono each received an 'A' grade on the Hospital Safety Grade from The Leapfrog Group in 2020, the highest grade in patient safety. These recognitions highlight LVHN's commitment to teamwork, compassion, and technology with an unrelenting focus on delivering the best health care possible every day. Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network. The Supervisor Coding Integrity & Denials supervises day to day operations of Coding Integrity Analysts. Activities may include lag day monitoring, workflow oversight, quality monitoring, productivity monitoring, and staff education. This role is accountable for the quality, timeliness, completeness, and accuracy of the coding integrity team to ensure optimal reimbursement and goal attainment. The supervisor conducts research on complex documentation and coding issues, provides documentation and coding advice related to Medicare and CMS regulations and third-party billing requirements, proactively identifies and resolves barriers to compliant coding, and assists other departments with coding related activities and issue resolution. The supervisor also assists the coding manager with coding related projects and staff oversight.

Requirements

High School Diploma/GED
5 years of experience in Coding Operations.
5 years coding in acute care setting or physician office setting.
Strong PC and MS Office Skills.
Knowledge of coding as applicable to role: ICD-10-CM/PCS, CPT/HCPCS/CPT, Evaluation & Management coding, Severity of Illness Classification, and modifier assignment.
Knowledge of medical terminology, A&P, pathophysiology, regulatory agency requirements.
Demonstrated skills in denials management.
Knowledge of practice management system and EMR.
CPC - Certified Professional Coder - State of Pennsylvania Upon Hire or CCS-P - Certified Coding Specialist-Physician Based AHIMA - State of Pennsylvania Upon Hire

Nice To Haves

Bachelor’s Degree Healthcare or Business.
2 years in a lead or supervisory role.
Knowledge of auditing and/or training/education processes and concepts.
Problem solving ability.
AR background.

Responsibilities

Supervises day to day operations of Coding Integrity Analysts.
Monitors lag day, workflow, quality, and productivity of coding staff.
Provides staff education.
Accountable for quality, timeliness, completeness, and accuracy of coding integrity team to ensure optimal reimbursement and goal attainment.
Conducts research on complex documentation and coding issues.
Provides documentation and coding advice related to Medicare and CMS regulations and third-party billing requirements.
Proactively identifies and resolves barriers to compliant coding.
Assists other departments with coding related activities and issue resolution.
Assists coding manager with coding related projects and staff oversight.
Monitors WQs and daily performance of coding staff to ensure accurate and timely billing of encounters/sessions in order to meet lag day goals.
Monitors staffing levels; approves, records, and updates staff PTO utilizing departmental policies.
Serves as the primary customer service contact for coding related issues with other colleagues and departments.
Stays current with ICD-10-CM and CPT guidelines to anticipate any coding changes.
Researches and reviews CMS and coding resources.
Assists with ensuring processes are also updated as applicable.
Analyzes coding trends and assists Coding Integrity Analysts with educating physician/practice staff on coding guidelines, and regulatory requirements.
Conducts research on complex or difficult issues, ensuring that policies and procedures are documented and accessible.
Assists Coding Manager with department staffing needs, including attending interviews, providing performance reviews, conducting employee coaching, and developing plans for performance issues.
Educates staff on policies/procedures.
Produces statistical data utilizing a variety of resources.
Assists with project management to reach department goals.
Works with Coding Manager to ensures optimal use of resources to achieve departmental goals.