10 Dec Medical Records Coding Manager

Medical Records Coding Manager supervises and trains a team of medical coders to ensure medical records are coded with accuracy and completeness. Ensures medical records coding operations follow the latest guidelines and compliance standards.

Pay Scale: Exempt

Reports To: Director of Revenue Cycle & HIM

Location: Seminole Hospital District

Responsibilities:

The Medical Records Coding Manager maintains required documentation and confidentiality of patient records. Implements processes for coding operations that support the needs of other healthcare partners. Additionally, Medical Records Coding Manager develops and maintains up-to-date knowledge of the latest ICD and CPT coding versions and ensures coders receive updates and training on classification or guideline changes.

Essential Functions

1. Responsible for assisting with hiring, evaluations, and disciplinary process of Coding team members in conjunction with the Revenue Cycle Director.
2. Applying the appropriate diagnostic and procedural codes to individual patient health information as conveyed by clinical members of the medical, nursing and ancillary staff.
3. Validating the ICD codes and DRG assignment appropriateness to ensure consistency and efficiency in inpatient claims processing and data collection to optimize DRG reimbursement and facilitating data quality in hospital inpatient services.
4. Maintain an expert working knowledge on regulatory agency and 3rd party payer rules and regulations as it relates to documentation, coding and billing processes, including maintaining appropriate credentials.
5. Interacts with physicians and other providers regarding billing and documentation policies and procedures.
6. Analyzes and interprets patient medical records to identify and determine amount and nature of billable services; assigns and sequences appropriate diagnostic/procedure billing codes in compliance with requirements of third-party payor requirements.
7. Interacts with physicians and other patient care providers both orally and in writing regarding billing and documentation policies, procedures, and regulations to ensure receipt and analysis of all charges; obtains clarification of conflicting, ambiguous, or non-specific documentation; as well as with Department leaders regarding implementation of new codes and revision of charge documents.
8. Drive operation efficiency and sustain excellence in coding workflow with accountability for meeting and exceeding established goals.
9. Maintains the confidentiality of employees, patients, administrative staff and medical staff information with no infractions.
10. Provides direct managerial oversight to vendors, coding leads, coordinator, and other positions in management of inpatient and outpatient coding functions, work queues, work processes, and overall work responsibilities.

Education and Experience Requirements

1. High school diploma or equivalent
2. Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) required
3. 3-5 years of coding experience in a critical access hospital

Skill Requirements

1.  Financial Management
2.  Leadership
3.  Business Acumen
4.  Project Management
5.  Problem Solving/Analysis
6.  Ethical Conduct
7.  Collaboration
8.  Personal Effectiveness/Credibility
9.  Strategic Thinking
10.  Communication Proficiency
11.  Thorough knowledge of functional area and department processes.
12.  Medical Terminology
13.  ICD Coding

Supervisory Responsibility: 

This position manages HIM and Coding staff.

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.

1. moderate periods of sitting/standing/walking
2. pushing/pulling
3. lifting/carrying >= 50 lbs.
4. crawling        
5. climbing        
6. kneeling/bending
7. visual acuity 
8. hearing acuity

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