As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost, and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!
Virtual work setting supervises daily operations specific to national coding services. Develop staff coverage strategies to maintain consistent productivity flow. Develops, executes and monitors individual coder quality and productivity.
Essential Duties and Responsibilities
Include the following. Others may be assigned.
- Supervises daily operations specific to coding operations and monitoring case assignments. Supports coding specialists by discussing complex coding cases, answering questions, providing education and interfacing with leadership.
- Develop, monitors and controls staff coverage strategies to maintain consistent productivity flow. Supervises business unit human resources by determining qualifications, competence and performance expectations; providing orientation; applying policies/procedures pertaining to human resources management.
- Continually assess and improve the business unit’s performance through data analysis and implementing sustainable performance improvement. Supports PFS RCS requests related to coding reviews. Supports RHIMD’s and Conifer clientele with national coding coverage. Onboard, orientation and training of new hires.
- Performs coding quality reviews in accordance with Conifer applicable monitoring policies of achieving 95% or higher.
- Assists in review for any patient audit presented from Conifer for coding / editing from coding staff. Organizes and reviews charts for coding audits and prepares action plans in response to audit findings.
- Tracks required educational updates and in-services.
- Monitors coding productivity to ensure productivity expectations are achieved
- Perform query reviews and manage escalation of unanswered queries/missing documentation needed for coding
Revenue Cycle Management
- Consistently monitoring of DNFC, DNFB and FBNE accounts to develop strategies to minimize un-coded accounts greater than bill hold days.
- Researches and monitors healthcare regulatory standards. Attends and participates in meetings and is responsible for coding related information communicated at meetings and between hospital clinical personnel.
- Attends relevant coding workshops to stay abreast of new and changing technologies. Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-9-CM and CPT coding.
- Attends mandatory coding seminars on annual basis (IPPS and OPPS, ICD-9-CM and CPT updates) for inpatient and outpatient coding. Quarterly review of AHA Coding Clinic. Attends Quarterly Coding Updates, all coding conference calls and CDI taskforce meetings.
- CDI: Communicates documentation improvement opportunities and coding issues (lacking documentation, physician queries, etc.) to appropriate personnel for follow-up, educational topics, and resolution
Knowledge, Skills, Abilities
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Strong leadership and communication skills, problem solving abilities; good knowledge of medical records systems.
- Ability to build and maintain team dynamics
- Strong computer applications knowledge including Microsoft Word and Excel.
- Must be fluent in general information technologies; significant level of autonomy; must be self-directed.
- Serve as a resource to PFS and other departmental contacts
- Implement policies and procedures that guide and support the provision of the services
- Advanced knowledge of ICD-10-CM, ICD-10-PCS and CPT coding principles and rules
- Intermediate to advanced knowledge of disease pathophysiology and drug utilization
- Intermediate to advanced knowledge of MSDRG and APR DRG classification and reimbursement structures
- Intermediate to advanced knowledge of APC, OCE, NCCI classification and reimbursement structures
- Coding proficiency demonstrated by successful completion of approved coding exercise
- Complies with all policies and procedures that pertain to HIPAA including minimum necessary requirements for this position. Must maintain 100% patient confidentiality for e-PHI during the course of work functions.
- Excellent organizational skills for initiation and maintenance of efficient workflow
- Capacity to work independently in a virtual office setting or at hospital setting if required to travel for assignment.
- Participates in meetings with CDIP and coding team.
- Provides or arranges for training of coding specialists as appropriate.
- Abides by the Standards of Ethical coding set forth by AHIMA and monitors coding staff for violations and reports as areas of concern are identified.
- Maintains knowledge of current professional coding certification requirements and promotes recruitment and retention of certified staff in coding positions.
- Develops reports and collects and prepares data for studies involving cases for clinical evaluation purposes and financial impact and profitability.
- Keeps abreast of new technology in coding and abstracting software and other forms of automation and stays informed about transaction code sets, HIPAA requirements and other future issues impacting the coding function.
- Demonstrates competency in the use of computer applications and grouper software, medical edits, and all coding and abstracting software and hardware.
- The supervisor should demonstrate initiative and discipline in time management and assignment completion.
- The supervisor must be able to work in a virtual setting under minimal supervision.
Education / Experience
Include minimum education, technical training, and/or experience required to perform the job.
- Five (5) years in relevant working field with one (1) year of supervisory experience acceptable.
- Prefer five (5) years experience in a supervisory role in healthcare with extensive knowledge of ICD-10-CM, ICD-10-PCS, CPT, HCPCS and documentation guidelines.
- Bachelor/Associate degree in Health Information Management and accredited by AHIMA.
Certificates, Licenses, Registrations
- Required: RHIA or RHIT AND CCS credential.