Inpatient Coding Manager
Comforce Corporation - Miami, FL

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Corporate Inpatient Coding Supervisor

Job Requirements:
Excellent leadership, verbal and written communication, problem-solving and personnel management skills. Knowledgeable in ICD-9 and CPT-4 coding conventions, pathophysiology, and managing DNFB reports. Proficient in health information systems, database management, spreadsheet design, and computer technology.

Job Summary/Purpose:
  • Assist in management and supervision of Inpatient coding, abstracting and reimbursement supporting billing and Compliance, ensuring efficient Operation
  • Supervises 7 A/R and ensures established goals and ICD-9 and CPT guidelines are met
  • Supervises and monitors overall Inpatient coding personnel (in-house and remote) activities to ensure accurate and timely processing in accordance to CMS and OIG
  • Supervises 16 FTE's projecting to increase to 27 FTE's by FY 2015

Essential Job Functions:
  • Serves as a 1st level supervisor to the Inpatient coding staff and their functions guiding activities, providing performance feedback, and answering their question as needed
  • Monitors overall compliance and data quality (i.e. discharge disposition, surgeon, etc.) reported to state and federal agencies for local and national data comparisons
  • Monitors and reviews quality of staff work product to ensure accurate Inpatient coding andabstracting of medical records for appropriate reimbursement and in accordance with CMS, OIG and hospitals policies
  • Ensures compliance with APR/DRG grouping guidelines for appropriate reimbursement
  • Assists coordinating RAC, FMQAI, and any other 3rd party payer perspective payment review activities
  • Reviews and corrects as needed claim denials and rejections pertaining to Inpatient coding for timely billing, reimbursement, and meeting A/R goals
  • Coordinates staff assignment and schedules to provide efficient coverage of Inpatient coding functions, as well as, optimal utilization of available human resources
  • Monitors accurate and timely completion of Inpatient coding to meet accounts receivable goals to facilitate timely billing
  • Monitors staff productivity to endure efficient process of Inpatient coding and abstracting of medical records in accordance to hospitals policies and goals in meeting A/R goals
  • Participates in the process of selection, counsel, evaluation, and reward of personnel to ensure high levels of quality, productivity, efficiency and job satisfaction in accordance to hospitals policies, procedures and service standards
  • Monitors compliance with Medical Necessity of NCD and LCD guidelines for appropriate reimbursement monitoring failed accounts and reporting outcome of opportunities for improvement
  • Orients, develops, and coordinates on the job training of new employees instructing staff on systems, procedures, and policies in accordance to coding outpatient compliance guidelines, hospitals policies, procedures and service standards
  • Monitors weekly DNFB report for 7 entities for pending Inpatient accounts not to exceed 30 days maintaining A/R goals and expediting billing and collection process
  • Must have successfully completed an approved coding program OR
  • Must be a graduate of a Health Information Management program.
  • At least three (3) years supervisory experience in a large healthcare institution and seven (7) years of Inpatient coding experience required
Required Certified Coding Specialist (CCS) with a Bachelor's degree in Health Information Management Administration (RHIA) or a degree in Health Information Management Technologist (RHIT) or an equivalent preferred.
  • Registered Health Information Management Technician (RHIT)
  • Registered Health Information Management Administrator (RHIA)
  • Certified Coding Specialist (CCS)
  • Must be able to demonstrate advanced knowledge of coding and abstracting skills.
  • Must score a minimum of 80% on a pre-employment coding test. - Must be able to demonstrate knowledge of reimbursement (Medicare and Medicaid) principles.
  • Must have extensive knowledge of medical terminology, the human disease process, anatomy and physiology.
  • Must be able to demonstrate good organizational and leadership skills.
  • Must be able to communicate effectively, both orally and in writing.
  • Must be able to demonstrate knowledge of computer software applications including MS Office.

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