Description Responsible for the daily operations, planning, organizing, staffing, directing, and controlling all functions of the Coding, Auditing and Compliance programs.
Responsibilities
Manages coding education by preparing and completing materials for internal and external audits, regulatory changes, and other changes in medical advancements.
Produces clinical data and statistical reports for clinicians, researchers, financial and business planning, and clinical quality support services.
Manages, oversees, and monitors the audit process for the coding and billing operations.
Conducts charge review and compliance audits of departments, and conducts training of personnel to ensure accurate and timely coding.
Directs, supports, and educates the physicians and other professional and support staff to ensure quality and consistency of ICD-10, CPT, and documentation guidelines.
Oversees accurate billing of charges to Medicare, Medicaid, and other third party payers according to insurance regulations and guidelines of each state where business is conducted.
Develops and maintains systems to insure efficient work flow and compliance to ensure data quality resulting in optimum reimbursement allowable under the federal and state payment systems.
Develops, implements and monitors policies and procedures, guidelines, and coding compliance plan for personnel in order to ensure compliance.
Provides direct supervision over the coding staff to ensure the timeliness and accuracy of coding and data collection activities.
Performs all other duties as assigned.
Qualifications
Education: Bachelors degree is required.
Demonstrated ability to teach and present educational topics required.
Strong knowledge of CPT and ICD-10 coding principles, governmental regulations, protocols and Electronic Medical Records (EMR) system.
Ability to apply judgment and making informed decisions.
Proven ability to manage a multitude of responsibilities while meeting objectives and working with teams.
Strong written, verbal and interpersonal communication skills.
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