HB Coding Supervisor - Reimbursement - Revenue Cycle

Overview

Job Summary

The Corporate Charge Operations Supervisor performs duties of moderate to high complexity, judgment, and scope. This position is responsible for coordinating day to day activities of the Corporate Charge Ops Specialists. S/he is responsible for the integrity of the charges and CPT/HCPCS coding assignments for optimization of revenue as well as coding compliance. S/he is responsible for providing necessary education and support to ensure the utmost integrity as required by The Centers for Medicare and Medicaid Services (CMS), other regulatory agencies, and contractual negotiations with other third party payers. This position works directly with revenue generating clinical departments and has collaborative relationships with General Accounting, Reimbursement, Patient Financial Services, SBO, Decision Support, Health Information Management and Compliance.
Essential Functions

• Coordinates day to day activities and work assignments of staff members.
• Tracks and manages productivity levels of delegated staff.
• Performs periodic reviews to ensure quality and accuracy of the code/charge assignments by staff, including feedback to staff with performance improvement plans, as appropriate.
• Assists in developing, coordinating and conducting training, education and development for new as well as established team members.
• Stays informed of most recent coding principles and regulatory guidelines and provides relevant information to customers and staff, as appropriate.
• Studies, reports, and make recommendations regarding compliance and/or revenue improvement.
• Interpret and clearly communicate payer rules and regulations to internal customers and teammates as needed.
• Works with and maintains a positive and professional relationship with applicable personnel involved in the service, documentation, charging, claims adjudication and revenue cycle to maximize accuracy, compliance and the overall process.
• Provides education to teammates and ancillary departments, as needed on subjects related to, but not limited to, charging, coding, reimbursement, policies and procedures, regulations, etc.
• Oversee periodic comprehensive reviews and ongoing refinement of the applicable clinical documentation and Charge Description Master(s) for revenue enhancement opportunities.
• Monitor reimbursement problem areas and work with staff to resolve issues.
• Maintain various monitoring reports and logs for distribution to members of management.

Physical Requirements
Works in a fast-paced office/hospital environment. Work consistently requires sitting and some walking, standing, stretching, and bending.

Education, Experience and Certifications

High School Diploma or GED required. AAPC or AHIMA certification, minimum of 5 years of experience of coding experience required, previous management experience preferred, strong knowledge of revenue cycle systems required. Maintain coding certification (CPC, CCS, RHIT, RHIA). Extensive knowledge of coding, medical terminology, anatomy, and physiology. Extensive knowledge of and the ability to apply the payer specific rules regarding coding, bundling, and adding appropriate modifiers. In depth knowledge of claim editing rationale and revenue cycle. Excellent written and verbal communication skills. Demonstrates expertise in multiple areas of coding.