Regional Coding Manager

 

JOB DESCRIPTION

 

Job Title Regional Coding Manager FLSA Exempt Reports to Director of HIM Operations Grade T Location Remote Band 3B

 

Summary/Objective
The Coding Manager is responsible assisting in the development and evolution of the overall strategy for the coding operations and for the overall coding compliance and daily coding operations including management of coding specific unbilled functions. This position will oversee onshore coding resources to include inpatient, outpatient, ED, and pro fee coders. The position will also coordinate with Omega offshore coding management and resources for offshore Outpatient and ED coding and act as a liaison to the client.

 

Essential Job Functions

• Provides overall management and direction of coding and abstracting activities. Oversee all duties and responsibilities of the coding staff.
• Must understand and demonstrate skill with the use of all Microsoft Office Suite of products such as Microsoft Word, Excel, and PowerPoint
• Responds to Coding/Abstracting data and report requests made by Client, physicians, and other internal customers.
• Utilizes database queries and reports to perform various auditing functions. 
• Works with the Medical Staff and other departments for resolution and education of coding, documentation, and reimbursement issues. 
• Develops and provides oversight for internal and external coding validation programs in conjunction with established client programs.  Identifies cases, monitors timeliness of data collection, aggregates, analyzes, and trends data. Provides summary and individual feedback to coding staff for performance improvement and compliance purposes.  Reports validation findings to Client on a monthly basis and identifies area for clinical documentation improvement and coder education.
• Maintains a knowledge base of various payment methodologies, grouping classifications and ICD-10 CM and ICD-10 PCS, as well as ICD-9.
• Provides ongoing training and in-service programs for coding staff to support corporate compliance. 
• Prepares and updates policies and procedures for Coding/Abstracting section, including internal coding guidelines. 
• Oversees that month end coding activity is closed out for abstracting purposes within the established client timelines. 
• Prepares monthly management reports on section productivity and quality. 
• Completes performance reviews, recommend and/or initiate employee selection, promotion, disciplinary and/or discharge actions. 
• Coordinates coding staff meetings, keeps staff informed of HIMS and regulatory changes, developments, and events. 
• Provides leadership and expertise in the areas of coding, compliance, reimbursement, and reporting of coded data. Understands flow of health information in the electronic health record from registration through documentation, discharge, coding, and billing. Ensures compliance with OIG, CMS, state Medicaid third party payer, RAC and additional state and federal auditing contractor regulations regarding coding and data reporting.
• Assists with system analysis, implementation, testing, database management, maintenance, accuracy, regulatory compliance, troubleshooting, and security of coding/abstracting systems, interfaces, databases, and reporting tools for systems using coding/abstracting data (e.g., 3M, Compass/Allscripts, EPIC, etc.). 
• Works with Client and IT Analysts to develop products to improve performance, efficiency, and data integrity. 
• Abides by the Standards of Ethical coding set forth by AHIMA and monitors coding team for violations and reports as areas of concern are identified
• Assists in the preparation and monitoring of the operating budgets. 
• Prepares and completes weekly Omega solutions metrics report.
• Work with Omega solutions team to perform vetting on candidates to assure appropriate client assignment.
• Meet budgetary goals per client agreement and achieves margins determined by Omega solutions
• Meet all SLAs for client engagement.
• Oversees management of accounts receivables (DNFB) and manages staffing resource