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RCM- Coding Manager Relevant Educational Qualifications Job

3 months ago Other categories Saint Louis Park   335 views
Job Details

Summary:

Coordinates, manages and oversees the revenue cycle quality assurance program across multiple locations and a remote work-force that will ensure industry best practices and outcomes.

Job Responsibilities:

Overall Description --

  • The coding manager is a critical thinker who creates business cases, influences stakeholders, and demonstrates command of the technical and industry knowledge. An effective team member who displays initiative and flexibility in team goal orientation in an ever-changing environment. The coding manager will prioritize and multi-task in a fast-paced environment, able to manage several projects simultaneously. The coding manager guides the coding and charge capture teams with tactical decision-making that will help align the quality of the accounts receivable interventions with industry best standards.

Impact --

  • Executes and implements key processes, standards and business plans in support of the Function, Segment and Business Unit strategy.
  • Establishes key elements of business plan with measurable contribution toward the achievement of results for the department; focus is on short-term results (e.g., goals of 3-6 months up to 1 year ).

Complexity --

  • Executes improvements to processes, systems, or products in order to enhance the performance of the coding team as well as the AR operations management team.
  • Problems and issues faced are moderately complex, and may require detailed information gathering, and analysis.

Influence & Communication --

  • Communicates regularly with parties within and outside of the coding and charge capture. Frequently interacts with subordinate and contract coders, global partners and functional peer groups. Periodically interacts with director or manager stakeholders across the enterprise. Typically communicates with parties inside the coding, compliance, and revenue integrity teams as well as throughout the operational or client management functions of the organization.
  • Strong presentation skills required, with ability to effectively communicate to leadership teams on KPIs and strategic priorities.
  • May work to justify and gain cooperation of other parties on practices, policies and procedures. Sometimes requires ability to influence others outside of own job area on policies, practices and procedures.
  • Participates in requests for proposal for coding resources, hiring, terminating, promotion, and reward decisions within area of responsibility.

Primary Responsibilities --

  • Set daily priorities, monitors accounts not coded, trains and supports coding specialists in assigning diagnoses and procedure codes for billing and statistical purposes.
  • Supervise external vendors who perform the majority of coding to ensure accuracy and compliance.
  • Monitor performance to assure compliance with policies and procedures and billing rules.
  • Ensure coding staff maintains a high quality and productivity standard and performs quality assessments on an on-going basis to identify areas where behavior is not compliant with expectations or where workflow improvements are needed.
  • Set expectations and allocate work utilizing KPI's to drive productivity and efficiency.
  • Train, instruct, and provide support to coding, charge entry and AR teams as appropriate regarding coding compliance, regulatory provisions, and third-party payer requirements.
  • Help to educate and inform physicians regarding inappropriate, incomplete or unclear coding.
  • Assure claim coding is supported by documentation and identify outliers based on clinical documentation, ensuring accuracy and proper reimbursement.
  • Monitor changes in laws, regulations, and policies that impact clinical documentation, reimbursement and coding to assure compliance.
  • Responds to coding related inquiries from providers and support staff and others as requested.
  • Responsible for daily supervision of employees including hiring, onboarding, managing work schedules, counseling, coaching, training and developing team members.
  • Prepares and delivers performance evaluations for team members. Provides regular feedback to team members regarding performance as needed to assure a high performing team.
  • Analyzes trends and meet with key stakeholders for the purposes of key information transfer.
  • Discover customer requirements and improve the service by incorporating feedback into service prioritization.
  • Develops and maintain a collaborative & effective communication protocol for notifying key staff when changes are made or need to be made to standard operating procedures and directives.
  • This position may have potential responsibility for SOC-II Controls.
  • This position may require knowledge of applicable data privacy practices and laws.
  • This role may have access to sensitive data to include PII and ePHI.
  • All employees of NextGen are required to complete annual HIPAA and compliance training.
  • All employees of NextGen are required to read and accept code of conduct upon hire and annually thereafter.

Education Required:

  • High School Graduate or General Education Degree (GED): Required.
  • Coding certifications such as CPC, RHIT, CCSP and/or other specialties.

Preferred:

  • Associates (two-year) Degree (four-year college or technical school) Preferred, Field of Study: Health Information Management (HIM), Business accounting, Healthcare Administration, Finance and Bookkeeping methods or similar field.

Experience:

Required:

  • Minimum of 5 years coding experience, Revenue Cycle Systems and Operations, and continual documentation improvement (CDI) program execution and management.
  • Requires broad management knowledge to lead project teams within a department.
  • Typically requires extensive prior relevant experience.
  • Reports to Director.
  • Supervises 3-5 direct reports plus vendor reports.
  • Current coding or other industry certification including certified professional coder (CPC), RHIT, CCSP and/or other specialties.

Knowledge, Skills & Abilities:

  • Microsoft Office Products and on-line training tools

  • Knowledge of and ability to identify what people need to learn for successful individual and organizational performance.

NextGen Healthcare believes in strength through diversity. We are an equal opportunity workplace and an affirmative action employer supporting Diversity, Disabled, and Protected Veterans. Qualified applicants are considered for employment without regard to age, race, color, religion, sex, national origin, sexual orientation, gender identity, disability or veteran status.

To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.

Because NextGen Healthcare believes in providing a safe work environment, we conduct background checks as part of our hiring processes.

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Company Description
Who We Are
We’re a leading healthcare solutions provider on a relentless quest to improve the lives of those who practice medicine and their patients.
We Believe A Healthcare Practice Should Be About Helping Patients
Why not work somewhere better? The road to better starts with a single step. Join us on our relentless quest to improve the lives of those who practice medicine and those they care for. Our goal? Healthier patients, happier providers, and happier employees.
We provide tailored solutions to fit the needs of ambulatory and specialty practices, as they strive to reach the quadruple aim while navigating the journey of value-based care.