About this role
JOB DESCRIPTION
Job Title
Coding Manager-SA
FLSA
Exempt
Reports to
Director of HIM Operations
Grade
M
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.
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
- 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 resources to accommodate daily patient volume within expected turn-around times and financial targets.
- Demonstrates the ability to attract, recognize, retain and manage staff and to effectively utilize staff to enhance the facilities and Omega solutions organizational performance.
- Regularly participates in virtual meetings, training, coaching, audits, and other work-related interactions using Company-approved collaboration technology, including audio and video, as required by Company or client.
- Performs duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance.
Key Success Indicators/Attributes
- Ability to prioritize and multi-task in a fast-paced, changing environment.
- Demonstrate ability to work in all work types and specialties.
- Demonstrate ability to self-motivate, set goals, and meet deadlines.
- Demonstrate leadership, mentoring, and interpersonal skills.
- Demonstrate excellent presentation, verbal, and written communication skills.
- Ability to develop and maintain relationships with key business partners by building personal credibility and trust.
- Maintain courteous and professional working relationships with employees at all levels of the organization.
- Demonstrate excellent analytical, critical thinking and problem-solving skills.
- Skill in operating a personal computer and utilizing a variety of software applications.
- Critical thinking skills demonstrated by the ability to make key decisions at client sites and with the oversight of direct reports without on-going feedback or supervision from upper management
Supervisory Responsibility
Yes
Work Environment
This job operates in an office environment. This role routinely uses standard office equipment such as computers and phones.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job:
- Stationary Position: Must be able to remain at a desk for prolonged periods for most of the workday.
- Operating Equipment: Constantly operates a computer, keyboard, mouse, and telephone/headset, including frequent repetitive hand/wrist motions for typing and prolonged periods of screen viewing and virtual communication.
- Visual Requirements: Requires close visual acuity to view computer screens, read documents, and analyze data.
- Cognitive Focus: Sustained concentration for problem-solving and task management, including ability to maintain concentrated attention to detail to ensure coding accuracy and compliance
- Communication: Frequently communicates with coworkers and clients via speech and hearing.
- Movement: Occasionally stands, walks, or reaches to access office equipment, files, or supplies. Light lifting of up to 10 pounds may occasionally be required.
Position Type
This position can be full-time or part-time as determined by the job requisition.
Expected Hours of Work
Days and hours of work are generally Monday through Friday, 8:00 a.m. to 5 p.m. This position occasionally requires long hours and weekend work.
Travel
Minimal travel required; up to 5%
Required Education and Experience
- Bachelor’s Degree or a combination of advanced formal training within the discipline and Dual Credential with Certified Coding Specialist (CCS).
- At least 3 years’ supervisory experience; minimum 5 years coding with inpatient and outpatient.
- AHIMA certification as an RHIA or RHIT
Preferred Education and Experience
Project management experience is a plus.
Additional Eligibility Qualifications
N/A
Security Access Requirements
In addition to the specific security access required by the employee’s client engagement, the employee will have access to the Omega systems set forth in the “Standard Field Employee” profile.
- Microsoft Office: E1 Level Access
- ADP: Standard Employee Level Access
- Oracle: Standard Level Access
- Reviewmate: Coder and Client Access based on client needs. Determined by manager and granted by Audit Implementation Manager
Equal Employment Opportunity:
Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcare also prohibits harassment of applicants or employees based on any of these protected categories.
Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources at [email protected] .
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Employee may perform other duties as assigned.
The candidate must possess excellent organizational skills and communication skills.
The candidate must be adept at utilizing computer programs and the internet.
Associate degree in a health-related field required
RHIT required with CCS certification