Coding Supervisor-Medicine

Oversight of coding services for reimbursement, supervision & development of staff and working with various department and staff members; auditing medical records to determine if billing reflects the care documented, and identifying areas of exposure and revenue enhancement based on CMS rules and regulations; providing education based on findings. Position emphasis placed on supervision of coding and billing for medical services.

 ESSENTIAL FUNCTIONS             

• Selects the appropriate procedural and diagnostic code based on provider documentation, utilizing HIPAA Standardized Code Set and applying CMS/payor guidelines.
• Ensures that teaching physician requirements are met and are clearly reflected in the documentation.
• Review provider codes and provide training and feedback on coding questions and issues.
• Assists billing staff with denials and charge correction requests as needed.
• Resolves coding TES and Claims Manager edits.
• Applies knowledge of government regulations as they relate to coding and billing of service.

 

EDUCATION and/or EXPERIENCE

• High school diploma or general education degree (GED) preferred
• Certified Professional Coder certification required
• Four to five years' experience in professional coding and/ or auditing; clinical background strongly preferred.
• At least 2 years of progressive supervisory experience
• Extensive knowledge of CPT and ICD-10 coding
• Knowledge of government regulations as they relate to teaching physician documentation 
• Understanding of the importance of compliance with all government, department, and contractual regulations regarding coding and billing; and provider requirements
• Knowledge of medical terminology, anatomy, and physiology