Job Description
KEY ACCOUNTABILITIES : 1. Is responsible for supervising the physician coding staff including orientation, training, performance development, competency assessment, and disciplinary actions.
2. Educates the coding team members and other healthcare professionals in the use of coding guidelines, proper documentation techniques, and functions.
3. Evaluates and determines integrity of coding controls and revenue generation is maintained at the highest possible level.
4. Supervises the coding of patient encounters and conducts internal coding audits for accuracy. Is responsible for the timely completion of coding and data / charge entry required in the revenue cycle process.
5. Establishes, implements, and maintains a formalized review process for coding compliance including a formal review (audit) process.
Designs and uses audit tools to monitor the accuracy of clinical coding. 6. Monitors Medicare and other payer bulletins and manuals, and reviews the current Office of the Inspector General (OIG) work plans for coding risks.
7. Performs data quality reviews on outpatient encounters to validate the International Classification of Diseases (ICD-9-CM), the Current Procedural Terminology (CPT), and the Healthcare Common Procedure Coding System (HCPCS).
8. Monitors medical visit code selection against facility specific criteria for appropriateness. Assists in the development of such criteria as needed.
9. Identifies patterns, trends, and variations related to provider benchmarks and payer denials. Investigates and evaluates potential causes and takes appropriate steps in collaboration with team members to affect resolution or explain variances. QUALIFICATIONS :
- High school diploma or GED
- Certified Professional Coder (CPC)
- Three years of leadership experience including leading work teams and / or projects
- Five years of coding experience PHYSICAL DEMANDS :
- Ability to move freely (standing, stooping, walking, bending, pushing, and pulling) and lift up to a maximum of twenty-five (25) pounds without assistance
- Job classification is not exposed to blood borne pathogens (blood or bodily fluids) while performing job duties WORK ENVIRONMENT :
- Use of computers throughout the work day
- Frequent use of keyboard with repetitive motion of hands, wrists, and fingers
- Normally works in climate controlled office environment
- Frequent sitting with movement throughout office space
REMOTE POSITION WITH OCCASIONAL IN PERSON MEETINGS
Monday-Friday, shift flexibility
Scheduled Weekly Hours :
Scheduled FTE : Location :
Location :
ThedaCare Corporate Office - Neenah,Wisconsin
Overtime Exempt :
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