Manager - Professional Clinical Coding

Description

MaineHealth Corporate

Management / Leadership

Req # : 4724

Fully Remote

This position manages Revenue Integrities Clinical Data Section, which is accountable for : coding and abstracting the medical records of Provider Based practice outpatient practice clinic claims i;

preparing statistical analysis of medical records data; compiling, analyzing and summarizing data from medical records into various formats.

The output of this Section is used for : meeting hospital licensure requirements; financial and billing purposes, which includes the identification and determination of appropriate reimbursement under inpatient and outpatient prospective payment systems;

maintenance of acceptable accounts / receivables and Pre A / R levels; compliance with internal and external regulatory agencies, such as Quality Improvement Organizations, the Centers for Medicare & Medicaid Services, and The Joint Commission.

Required Minimum Knowledge, Skills, and Abilities (KSAs)

1. Education : Advanced education which should include communication and mathematical / statistical skills and / or extensive knowledge in organization, research and analysis normally acquired through the completion of Health Record Administration / Technician / Science Bachelor's / Associate Degree program, preferred.

2. License / Certifications : Certification in one of the follow areas required : RHIA / RHIT, CCS, CPC. Skilled in ICD10 diagnosis and CPT coding and knowledge of Provider Based Billing practices.

3. Experience : A minimum of two years prior successful supervisory experience required; Experience with EPIC, claim edit processes, encoder software and CDI programs, preferred.

4. Full working knowledge of : medical information and revenue cycle systems; Grouper and Severity of Illness Systems; medical record systems, medical terminology, anatomy, physiology, pathophysiology, microbiology, and pharmacology;

State, Federal and Joint Commission requirements pertaining to medical records; Provider Based payment systems, preferred.

5. Demonstrated abilities to : correctly interpret and apply Federal regulations and PRO requirements in the interpretation of various billing guidelines (i.

e., medical necessity, resident supervision policies, correct coding initiative, etc. Ability to direct concurrent and retrospective coding reviews and provide physician education, required 6.

Effective skills in leadership, communications, coaching, planning, motivation, and establishing effective working relationships with at all levels of staffing in the organization.

Additional Information

With a career at any of the MaineHealth locations across Maine and New Hampshire, you'll be working with health care professionals that truly value the people around them - both within the walls of the organization and the communities that surround it.

We offer benefits that support an individual's needs for today and flexibility to plan for tomorrow - programs such as paid parental leave, a flexible work policy, student loan assistance, training and education, along with well-being resources for you and your family.

MaineHealth remains focused on investing in our care team and developing an inclusive environment where you can thrive and feel supported to realize your full potential.

If you're looking to build a career in a place where people help one another deliver best-in-class care, apply today.