Coding Resources Coordinator

The Coding Resources Supervisor is responsible for the supervision of the staff and the daily operations of the Coding Resources Department and is responsible for personnel management, orientation and training and ongoing education. Coding Resources Supervisor ensures compliance to governmental, departmental and other regulatory regulations, policies and procedures.

Essential Job Functions

• Supports and models behaviors consistent with the mission and philosophy of Billings Clinic, Coding Resources, and Patient Financial Services.
• Provides leadership for the review, analysis, and interpretation of regulations and standards to ensure appropriate coding, adherence to third-party payer regulations and standards, and maximum reimbursement for services rendered, and implements standards in practice. Responsible for overseeing the coding and analysis of the diseases and surgical procedures after discharge for statistical and reimbursement purposes for services, evaluation, and management codes, as well as analysis of data from the medical record for challenges to insurance reviewers and payers, and patients to resolve low payments and offer appeals to overturn payment denials.
• Supervises the Coding Resources staff, including directing and coordinating day-to-day activities, ensuring adherence to quality indicators, establishing priorities and assigning workloads, and scheduling.
• Responsible for personnel management to include interviewing, hiring, orientation/training, performance appraisal, coaching/counseling, and disciplinary action.
• Maintains application or systems files that impact the department, continually updating files. Coordinates with Information Services in the design, update, scheduling, and problem resolution of information systems utilized by the department.
• Participates in the budgetary process and operates within established budgetary constraints and long and short-term planning for the department.
• Prepares and analyzes reports on the department's status and efficiency, using various reporting tools.
• Participates in the development and maintenance of departmental policies and procedures and in process improvement initiatives.
• Oversees payer regulatory billing and reimbursement training and education to staff to communicate coding and documentation requirements, and provides statistical and specialized coding and reimbursement studies. Utilizes multiple coding and payer regulations, directions, and guidelines to ensure and facilitate accurate coding and sequencing of diagnoses and procedures by following the fiscal intermediary guidelines to ensure maximum reimbursement for services rendered. Reviews medical record for medical information to identify principal diagnosis and procedure, and all applicable secondary diagnoses and procedures (pre-pay audits).
• Maintains competency in all organizational, departmental, and outside agency safety standards relevant to job performance and ensures staff compliance with all requirements.
• Performs other duties as assigned or needed to meet the needs of the department/organization.

Minimum Qualifications

Education

• High School or GED Experience
• 2 of leadership or supervisory experience, preferred
• 2 experience in a multi-specialty clinic/hospital working with ICD-CM, CPT-4/HCPCS, PCS and DRG coding
• Previous demonstrated experience in a clinic/hospital setting performing technical responsibilities related to ICDCM, CPT-4/HCPCS, PCS and/or DRG coding, billing, fees and reimbursement
• Demonstrated ability to understand and develop information using databases and creating complex spreadsheets Certifications and Licenses
• Credential as Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC) or Certified Coding Specialist (CCS), or other AHIMA or AAPC recognized coding credentials Or an equivalent combination of education and experience relating to the above tasks, knowledge, skills and abilities will be considered. Employees that require a licensed or certification must be properly licensed/certified and the licensure/certification must be in good standing.