Location: Granger,IN, USA
Summary
Reports to the Director, Corporate Coding and CDI. Responsible for the management of the day to day medical record data abstraction and coding functions. Works with the Director to develop, update, and implement policies and procedures to ensure compliance with Beacon Health System and regulatory requirements. Functions as an expert on patient data and assists with coded information requests. Works with the Director on project planning, troubleshooting, software testing, quality assurance activities and ongoing data maintenance of the designated coding software system applications.
MISSION, VALUES and SERVICE GOALS
* MISSION: We deliver outstanding care, inspire health, and connect with heart.
* VALUES: Trust. Respect. Integrity. Compassion.
* SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.
Maintains professional knowledge, managerial skills, and competence in areas of responsibility by:
* Ensuring that scheduling, work assignments and work oversight are provided to meet quality and timeliness objectives.
* Participating in the hiring process by interviewing candidates.
* Evaluating the performance of staff, coaching, and carrying out the disciplinary process when necessary.
* Ensuring that job related training is provided for reportable staff members and developing training programs for each new staff member. Ensuring staff continuing education needs are met.
* Interpreting, enforcing, and supporting Beacon Health System policies, procedures and protocols.
* Conducting and/or assisting the Director with monthly meetings for reportable staff.
Manages staff assigned to the Coding unit by:
* Developing, updating, and implementing policies and procedures that promote high quality and efficient processes and that ensure compliance with Beacon Health System and regulatory requirements.
* Supervising or conducting quality audits on staff to ensure that the work completed is accurate, timely and completes; documenting the results of these studies and reporting the findings and recommendations for corrective action to the Director.
* Managing staffing hours and supplies within the department budgeted allowances.
* Assuring that accounts pending coding (days to billing) are maintained at an acceptable level.
* Manages and monitors the coding function to ensure high quality, timely output by:
* Researching rejections to determine reason(s) for denial and correcting records to ensure proper billing.
* Serving as a liaison to Patient Accounting and other clinical departments on coding issues; serving as an ad-hoc participant on the Revenue Cycle Strategic Roadmap.
* Helping to identify ways to optimize reimbursement, while maintaining the highest compliance standards.
Facilitates compliance with governmental billing requirements, including but not limited to Diagnostic Related Groups (DRG), Ambulatory Payment Classification (APC) reimbursement systems and Medical Necessity Policies by:
* Maintaining professional certification and affiliations as appropriate.
* Attending in-services and department meetings; also participating in continuing education and attending conferences as approved.
* Reviewing trends and developments in coding methodology and reimbursement; sharing this information with coding staff.
* Reading current professional literature and journals, including but not limited to AHAs Coding Clinic, AMAs CPT Assistant, updates from Beacons Medicare Administrative Contractor, updates from the Center for Medicare and Medicaid Services (CMS), annual updates to the International Classification of Diseases 10th revision Clinical Modification (ICD-10-CM) and Current Procedure Terminology (CPT).
* Recommending new policies and procedures to enhance the Coding software system build and workflow processes to the Director.
In conjunction with Information Systems, performs duties related to implementation, upgrades, maintenance and problem resolution of designated Coding software system applications by:
* Monitoring Coding software system applications and projects in progress (and also those in the development stage) and providing periodic status reports to the Director and Information Systems Department.
* Assisting with the ongoing data maintenance of designated Coding software systems and establishment of data maintenance guidelines.
* Utilizing Coding software systems to retrieve information and reports. Monitoring data and reports to ensure the integrity and accuracy of data.
* Interfacing and working closely with departmental employees to ensure the accuracy of the data transfer and the building of rules and tables.
* Communicating the details of the Department's operational requirements, both routine and unique, for the implementation and upgrade of Beacon Health System software systems as required. Also assists with tailoring computer system applications to meet the unique requirements of the Department.
* Analyzing, documenting and correcting operational problems. Identifying potential problems which will require the assistance of an I.S. staff member.
* Ensuring that the computerized encoder system is properly maintained and all system backups performed in a timely manner.
* Supervising the testing of system functionality, as well as assisting with the validation of database integrity.
* Acting as a liaison and facilitator with end users throughout the implementation of new Beacon Health System software systems and software upgrades.
Contributes to the overall effectiveness and efficiency of the department by:
* Maintaining up-to-date knowledge regarding the department's day-to-day operations.
* Completing other job-related assignments and special projects as directed.
Leadership Competencies
* Drives Results - Consistently achieving results, even under tough circumstances.
* Customer Focus - Building strong customer relationships and delivering customer-centric solutions.
* Instills Trust - Gaining the confidence and trust of others through honesty, integrity, and authenticity.
* Collaborates - Building partnerships and working collaboratively with others to meet shared objectives.
* Communicates Effectively - Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences.
ORGANIZATIONAL RESPONSIBILITIES
Associate complies with the following organizational requirements:
* Attends and participates in department meetings and is accountable for all information shared.
* Completes mandatory education, annual competencies and department specific education within established timeframes.
* Completes annual employee health requirements within established timeframes.
* Maintains license/certification, registration in good standing throughout fiscal year.
* Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
* Adheres to regulatory agency requirements, survey process and compliance.
* Complies with established organization and department policies.
Commitment to Beacon's six-point Operating System, referred to as The Beacon Way:
* Leverage innovation everywhere.
* Cultivate human talent.
* Embrace performance improvement.
* Build greatness through accountability.
* Use information to improve and advance.
* Communicate clearly and continuously.
Education and Experience
* The level of knowledge, skills, and abilities listed below are normally acquired through the successful completion of an Associate's Degree in Health Information Technology from an accredited college or university. The Certified Coding Specialist (CCS) certification is required. A Bachelor's Degree and/or attainment of the Registered Health Information Administrator (RHIA) certification is desirable. A minimum of three years of experience in ICD and CPT coding in a large acute care facility and three years coding supervisory experience with large acute care hospital and/or health system. Current accreditation with the American Health Information Management Association (AHIMA) required.
Knowledge & Skills
* Requires thorough knowledge of medical terminology, anatomy and physiology, and coding systems.
* Requires thorough knowledge of the ICD-10-CM and ICD-10-PCS classifications, CPT classification and the DRG and APC reimbursement systems.
* Requires thorough knowledge of coding policies, guidelines, and practices.
* Demonstrates advanced knowledge of departmental day-to-day operations and policies and procedures. Also requires a solid understanding of user department processes and procedural changes and how Beacon Health System departments interact with each other in a computerized environment.
* Requires the technical computer skills and knowledge necessary to effectively use and support various software and hardware. Also demonstrates a working knowledge of database applications and the skills needed to assist with testing plans and data.
* Demonstrates the interpersonal and communication skills (both verbal and written) necessary to communicate effectively with the staff at all levels. Also requires the ability to provide effective training.
* Requires organization skills and the ability to work independently as assigned, prioritize workload and handle a variety of multiple and overlapping functions within set deadlines.
* Demonstrates the leadership skills necessary to elicit cooperation and support from other staff members.
Working Conditions
* Works in an office environment.
Physical Demands
* Requires the physical ability and stamina to perform the essential functions of the position.