Position Highlights:

The Mid Revenue Cycle Manager Coding Education and Quality will oversee all activities related to the Heath Information Management and Revenue Integrity education and quality programs. The position creates, implements and supervises the education curriculum to address the needs of the Mid Revenue Cycle staff to ensure compliance with accurate coding based on applicable guidelines and federal regulations. It creates, monitors and supervises curriculum to address the clinical team - providers and nurses - needs on improving clinical documentation to support the professional and facility services provided to our patients.

This position supervises the Coding Education supervisors assisting them in the development of productivity measures and quality controls.

This position is responsible for performing data review to report metrics and trends to assist in decision making. This position is expected to be a Subject Matter Expert in professional practice and facility coding of diagnoses and procedure information that uses International Classification of Diseases, Tenth Revision, Clinical Modification ("ICD-10 CM"), Current Procedural Terminology ("CPT"), Evaluation and Management ("E&M") coding and Healthcare Common Procedure Coding ("HCPCS") coding, as well as Hierarchical Condition Category (HCC) coding, Merit- based Incentive Payment System (MIPS) coding, Provider Relationship (PR) coding and Appropriate Use Criteria (AUC) coding.

Responsibilities:

• Leads and manages all functions related to the establishment of a strong and efficient team including but not limited to the hiring process to the meeting of goals
• Oversees all aspects of education and quality initiatives
• Oversees timely communication and distribution of changes and updates of coding guidelines, rules and regulations impacting coding and billing of clinical service performed
• Time Management - ensure that all coding audits are completed and all edits are resolved in a timely manner.
• Alert manager of coding in identifying and analyzing problems or issues that prevent coding audits or correction of edits.
• Review, monitor and approve all Coding Educator staff time in Kronos system.
• Creates a process to obtain accreditation for all the education curriculum created by the coding education team to ensure Continue Education Units ("CEUs") for the staff
• Oversees all efforts related to audits reviews.
• All other duties as assigned.

Minimum Licensure/Certification Required:

• Any "one" of the following certifications is required:
  • (CPC-H) Cert Professional Coder-Hosp
  • (CCS) Certified Coding Specialist
  • (CPMA) Professional Certified Medical Auditor
  • (CPC) Cert Professional Coder
  • (COC) Certified Outpatient Coding
  • (CCS-P) Certified Coding Spec-Phys
  • (RHIT) Reg Health Info Technician
  • (RHIA) Reg Health Info Administrator
  • *Any relevant certification not listed above may be reviewed and considered by the business to satisfy this requirement

Credentials and Experience:

• Bachelors degree and a minimum of seven (7) years health care coding experience with ICD-10-CM, CPT and HCPCS classification systems for evaluation management coders; inclusive of a minimum of three (3) years' leadership experience as a team/project lead, supervisor, manager or above. One certification (as stated in the certification section above) is required upon hire.
• In lieu of a Bachelor's degree, an Associate's degree with two (2) additional years of experience as
  stated above, may be considered (total nine (9) years' experience).
  (OR)
• High School/GED with eleven (11) years' experience as stated above, may be considered.
   

Additional Experience:

• One of the above mentioned certifications is required.
• Ability to communicate in a professional manner to internal and external customers.
• Thorough understanding of the effect of data quality on prospective payment, utilization, and reimbursement for multiple medical specialties.
• Thorough understanding of quality measures and compliance guidelines.