About Us:
Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.
We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.
Roles and Responsibilities:
Oversees the daily operations of the coding unit including workload and staffing;
hiring, disciplining, and performance appraisals; training; and monitoring quality of
work.
Develops longrange and shortterm goals, objectives, plans, and programs and
ensures they are implemented.
Assists in planning, developing, and controlling the budget, including staffing costs,
capital equipment, and operations of the coding unit.
Evaluates the impact of innovations and changes in programs, policies, and procedures
for the coding unit.
Designs and implements systems and methods to improve data accessibility. Identifies,
assesses, and resolves problems. Prepares administrative reports.
Oversees and monitors the coding compliance program. Develops and coordinates
educational and training programs regarding elements of the coding compliance
program such as appropriate documentation and accurate coding to all appropriate
staff.
Ensures the appropriate dissemination and communication of regulatory, policy, and
guideline changes.
Conducts and oversees coding audit efforts and coordinates monitoring of coding
accuracy and documentation adequacy.
Reports noncompliance issues detected through auditing and monitoring, the nature
of corrective action plans, and the results of followup audits.
Conducts trend analyses to identify patterns and variations in coding practices.
Reviews claim denials and rejections pertaining to coding and medical necessity issues
and, when necessary, implements corrective action plan to prevent similar denials and
rejections from recurring.
Required Expertise & Qualification:
Life Science graduation or any equivalent graduation with Anatomy/Physiology as
main subjects.
Master’s degree in business administration preferred.
10 12 years of overall coding experience, out of which a minimum 5 years in team
handling of a team size ranging between 250 to 600 team members.
Any one of the following coding certifications CPC, COC, CRC, CPCP from AAPC CCS,
CCSP, CCA from AHIMA
Excellent communication skills, both verbal and written.
Strong managerial, leadership, analytical and interpersonal skills.
Outstanding organizational skills.
Hands on Experience in generating reports using MS Office Excel, word and MS power
point.
PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
