Supervisor Inpatient Coding

HonorHealth•Phoenix, AZ

2d•Onsite

About The Position

This position oversees workflow and productivity for system health record coding and abstracting functions, including DRG (inpatient) and APC (outpatient) assignment and validation. It provides resources to hospitals, surgery centers, and clinics to maintain the discharge-not-final-billed (DNFB) turnaround process and productivity standards. The supervisor leads the assigned section and participates in departmental administration, including hiring, evaluating, and terminating employees. The role works closely with the Network Coding Manager and Senior Network HIM Director to support timely reimbursement and billing, monitor the DNFB report, and develop ways to reduce DNFB. The supervisor establishes system-wide policies, procedures, and operational benchmarks for inpatient and outpatient coding; serves as a resource for coding staff; coordinates monthly education for coding staff and ancillary personnel; and stays current with federal legislation and coding and reimbursement guidance. The role sets priorities and schedules to meet billing and reimbursement timelines, monitors incomplete abstracts, assigns and sequences diagnosis and procedure codes for inpatient and outpatient accounts, supports special projects and training, monitors customer service quality, and implements HIM process improvements. The position requires at least one active inpatient certification: CCS, CIC, RHIT, or RHIA. Outpatient certification options are also listed as required. Associate-level education or two years of related work experience is required; a bachelor's degree is preferred.

Requirements

At least one active inpatient certification: CCS (Certified Coding Specialist), CIC (Certified Inpatient Coder), RHIT, or RHIA (Registered Health Information Administrator).
Associate degree or two years of related work experience required.
Two years of inpatient hospital coding lead, auditor, or trainer experience and working knowledge of hospital inpatient charging and billing processes required.
Two years of outpatient coding lead, auditor, or trainer experience and working knowledge of charging and billing processes for at least three listed specialty work types required.
Three years of coding and encoding software experience required.
Hospital coding experience, including complicated accounts and long-length-of-stay accounts, required for inpatient work.
Working knowledge of coding edits and guidelines including Medicare, NCCI, OCE, LCD, and NCD required for outpatient work.
Outpatient certification required: CPC-H, CPC, COC, CCS, RHIT, or RHIA.

Nice To Haves

Bachelor's degree preferred.
Five years of inpatient hospital coding lead, auditor, or trainer experience and working knowledge of inpatient charging and billing processes preferred.
Five years of outpatient coding lead, auditor, or trainer experience and working knowledge of charging and billing processes for at least three listed specialty work types preferred.
Five years of coding using encoder software and supervisory experience preferred.
RHIT or RHIA preferred for inpatient/outpatient coding.

Responsibilities

Oversee workflow and productivity for health record coding and abstracting, including inpatient DRG and outpatient APC assignment and validation.
Provide resources to hospitals, surgery centers, and clinics to maintain DNFB turnaround and productivity standards.
Lead the assigned section and participate in departmental administration, including hiring, evaluating, and terminating employees.
Work with the Network Coding Manager and Senior Network HIM Director to support timely reimbursement and billing, monitor DNFB, and develop ways to reduce DNFB.
Establish system-wide policies, procedures, and operational benchmarks for inpatient ICD-10-CM and ICD-10-PCS coding and outpatient ICD-10-CM, CPT, and HCPCS coding.
Serve as a resource for coding staff on questions, situations, and problem solving.
Plan and coordinate monthly educational forums for coding staff and ancillary personnel on correct coding and payer billing and reimbursement compliance.
Stay current with federal legislation, periodicals, and publications related to coding and reimbursement compliance.
Set priorities and schedules to meet reimbursement and billing suspense-day targets, including monitoring the failed-bill (incomplete abstract) report.
Participate collaboratively in special projects, training, and other duties assigned by the Network Coding Manager.
Assign and sequence ICD-10-CM and ICD-10-PCS codes for inpatient accounts for billing and reimbursement.
Assign and sequence ICD-10-CM, CPT, and HCPCS codes for outpatient, observation, ambulatory, and emergency-room records for billing and reimbursement.
Monitor the quality of customer service provided to internal and external customers and medical staff, and address complaints of inadequate service.
Initiate, prepare, and implement process improvements and other projects to maximize system-wide HIM effectiveness.
Perform other duties as assigned.