Supervisor, Outpatient Coding
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- Savannah, GA
- Physician Network - Central Billing Office
- Full Time - Days
- Req #: 2917-10508
Summary
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Position Summary
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Medical coding is bound by a complex set of rules and regulations. The Outpatient Coding Supervisor must have extensive knowledge of ICD-10-CM diagnosis coding guidelines, CPT codes and modifier rules, including HCPCS codes, and Pro-fee coding guidelines. This Supervisor is responsible for monitoring governmental and non-governmental payer coding changes and is to be proactive with sharing this information across applicable departments, on behalf of the SJC Medical Group Central Business Office. This Supervisor is directly responsible for developing and monitoring CBO coding workflows, as well as managing applicable staff to ensure productivity and quality goals are met. This Supervisor collaborates with all members of the SJCMG CBO Leadership Team to promptly identify coding relevant denials and other negative trends across all Insurance plans. This Supervisor provides coding guidance to all SJCMG CBO co-workers, as well as researches complex interdepartmental coding issues in conjunction with the SJCMG Documentation Specialist. This Supervisor serves as a direct coding resource to SJCMG Administration. Must have and maintain AAPC credentials (CPC), mentor new coders and support co-worker development. This Supervisor conducts new hire processes, performance evaluations, and performance improvement plans for applicable co-workers. Must be able to apply policies and procedures to solve every day problems and deal with a variety of time sensitive situations.
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Education
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Associate of Health Information Administration - Preferred
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Experience
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3-5 Years Coding and Revenue Cycle Management - Preferred
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Proficient in use of spreadsheets and skilled in gathering, analyzing and evaluating data to uncover aberrant patterns of coding and billing. Must have knowledge of Revenue Cycle processes, specifically the workflows from clinical charge entry to coding through billing and denials. Written and verbal communication skills, time management skills, and proven ability to reach across departments to problem solve.
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License & Certification
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National Certification - Required
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AAPC credentialed as CPC.
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Core Job Functions
- Provide leadership to staff in goal setting, problem solving, resource management, and outcome achievement. Demonstrate fiscal accountability for department resources and the ability to achieve outcomes within allocated resources. Demonstrates a clear understanding of regulations applicable to patient care and/or department functions.
- Appropriately provides coding assistance to providers and co-workers. Maintains certification as a Professional Coder according to national standards annually. Accurately provides coding updates to provider locations on behalf of the billing department.
- Significant billing and/or payer issues are communicated. Coordinates financial reporting, analysis for monthly reports.
- Hires, trains, counsels, disciplines and terminates staff as needed. Responsible for updating co-worker files such as performance evaluations, clinical competencies, job descriptions, organizational chart, Halogen module and site orientations. Ensure system HR policies and procedures are adhered to in all assigned practices. Responsible for monitoring staff time, and approving staff payroll each pay period.
- Assigns diagnosis and procedure codes to complex outpatient encounters according to coding rules and regulatory requirements. Uses encoder to invoke national correct coding and outpatient code edits; appropriately appends modifiers to resolve edits.