Coding Quality Manager at US Acute Care Solutions

10 months ago QA Middle Full-Time 59,000-98,000 $/Year

We offer career opportunities for clinicians and non-clinical support staff from New York to Hawaii and numerous points in between.


KNOWLEDGE, SKILLS, AND ABILITIES:

  • Knowledge of and skill in using personal computers in a Windows environment with an emphasis on Excel, Word, and PowerPoint.
  • Knowledge of inventory management techniques.
  • Knowledge of payer coding & billing guidelines. Knowledge of and experience using ICD-10-CM and CPT-4 coding.
  • Ability to identify emerging issues and communicate them to management.
  • Ability to communicate with employees, management and physicians in a courteous and professional manner with emphasis on giving detailed oral and written instructions and explanations.
  • Ability to maintain confidentiality.
  • Ability to pay close attention to detail.
  • Ability to effectively perform in a multi-task work environment.
  • Ability to work overtime and put forth extra effort when needed.


Description

Where do you belong?

Your career is more than just a job, it's part of your life. Whether you’re a clinician, or non-clinical professional, at USACS you'll feel a sense of connection working with clinicians and office staff who share your interests and values. We want you to love coming to work each day because you believe in what you do and the people with whom you work. We care about your success.

USACS also understands that location is important. We offer career opportunities for clinicians and non-clinical support staff from New York to Hawaii and numerous points in between. Our supportive culture, outstanding benefits and competitive compensation package is best in class.

Job Description

The Coding Quality Manager responsible for managing the improvement of accuracy, integrity and quality of coding practices and oversees the educational development plans for the coders. The manager reviews coding quality performance, develops and maintains policies and procedures that will improve and support overall revenue cycle function and organizational goals- as well as promote timely and accurate coding to comply with all organizational policies, CMS & OIG guidelines and other applicable regulations. The manager will utilize project management skills, coding knowledge and understanding of documentation and coding requirements to improve processes and compliance.

Location: Remote

ESSENTIAL JOB FUNCTIONS:

  • Administers human resource matters including: recruiting, hiring, scheduling, career development, performance evaluations, and corrective action.
  • Drives continuous improvement by developing, prioritizing & monitoring improvement activities & key performance metrics.
  • Ensures that employees are adhering to company and department policies and procedures.
  • Communicates with staff and other personnel to resolve issues, achieve department & corporate objectives.
  • Maintains knowledge of current trends and practices in coding principles and government regulations through reading materials and/or attendance at educational meetings or seminars.
  • Schedules and contributes to department meetings; participates in Quality Assurance meetings.
  • Gains familiarity with all aspects of company and department & their impact on company financials.
  • Sets performance standards and conducts annual evaluations on staff; drives educational programming, if necessary, to improve quality.
  • Responsible for the maintenance and improvement of the established Coding Quality Assurance Program by collaborating with the coding quality team, leads, clinician education, coding operations managers, compliance, etc. to develop coder and auditor ongoing and periodic education
  • Responsible for the integrity of the quarterly coding accuracy rates and provides unbiased recommendation to initiate Corrective Action Plans
  • Responsible for ensuring the lead understands how to monitor daily coding quality operations and prioritization of duties, including managing production auditing inventory, team updates, educational materials and research.
  • Maintains positive relationships and facilitates effective communication amongst Coding Operations, Clinician Education, Compliance, Front & Back-end RCM, etc.
  • Participates in any programs & services workgroup meetings and responsible for forecasting any quality impact to the coding department such workflow changes, coders’ education, physician documentation, etc.
  • Assesses current compliance activates; evaluates risk factors in coding and related processes; and ensures guidelines are compliant with federal, state, and other applicable regulations
  • Develops and monitors the success of a quality data management plan, analyses and reports data, investigates identified issues and takes appropriate improvement steps
  • Responsible for determining resource needs by working closely with Sr. Director.
  • Monitors vendor coding accuracy rate including RVU distribution trend.
  • Communicates vendor quality and addresses scheduling questions or concerns on the weekly or bi-weekly vendor calls or through email as needed
  • Coaches and helps develop team members; helps resolve dysfunctional behavior and promotes teamwork within functional area(s); disciplines and counsels’ staff as necessary
  • Proactively manages (including corresponding communications and escalation paths) significant issues in coding, status of projects, barriers and successes
  • Assists in identifying and implementing process improvements to decrease coding related cost to collect Openly communicates issues and opportunities to appropriate person(s)
  • Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and American Academy of Professional Coders and adheres to official coding guidelines.
  • Ability to exhibit leadership by demonstrating a commitment to teamwork, supporting alignment with company and department goals and objectives, assisting others to develop their knowledge of the company and department, adapting to change in a positive manner that exemplifies commitment, and working proactively with minimal supervision.
  • Ability to resolve conflict by persuading others through explanation to accept a course of action and approaching conflict from a positive viewpoint rather than a negative one.

EDUCATION AND EXPERIENCE:

Associate or Bachelor Degree in healthcare/business field (or equivalent professional experience) required.

Coding/medical records experience and leadership/supervision experience required.

RHIT, RHIA, CCS-P, CPC, RN or other job-related accreditation preferred.

Salary Range: $59,364 - $98,940

Salary may be determined on several factors including but not limited to knowledge, skills, experience, education, geographical location and requirements stated in job description

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