MG Supervisor Non-clinical Ex

SUMMARY

Reports to Manager of Ambulatory Coding and works with Manager of Coding to develop workflow processes and provides direction and supervision to staff responsible for accurately coding medical records, auditing charts and resolving work queue edits, EDI error and payor denials associated with coding related issues. Collaborates with the overall physician revenue cycle department to meet the metrics, mission, vision and values of the Brown University Health Organization.

Brown University Health employees are expected to successfully role model the organization’s values of Compassion, Accountability, Respect and Excellence, as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done.

The core Success Factors include:
Instill Trust and Value Differences Patient and Community Focus and Collaborate. In addition, our leaders will demonstrate an aptitude for:
Ensure Accountability and Build Effective Teams Drive Vision and Purpose and Optimize Work Processes. By applying core and leadership competencies, leaders help Brown University Health achieve its strategic goals.

• Supervises the coding activities for any area or a combination of the following: observation, partial hospital, dialysis, radiology, radiation oncology, VIR, NIR, Cath Lab, pathology, lab, ambulatory clinics (adult and/or pediatric, cardiovascular institute, oncology), ambulatory surgery, emergency department, anesthesia, office and hospital professional coding.
• Ensures highest level of accuracy, completeness and timeliness of processes in code assignment.
• Ensures consistency and efficiency in outpatient claims processing and data collection to optimize reimbursement and facilitate data quality in outpatient services.
• Consistently applies the corporate values of respect, honesty and fairness and the constant pursuit of excellence in improving the health status of the people of the region through the provision of customer‑friendly, geographically accessible and high‑value services within the environment of a comprehensive integrated academic health system.
• Is responsible for knowing and acting in accordance with the principles of the Brown University Health Corporate Compliance Program and Code of Conduct.
• Monitors unbilled accounts for uncoded or outstanding accounts to ensure the cases are completed within 2‑3 days of discharge.
• Maintains efficient workflow in coding and clerical processes; prioritizes high paying accounts.
• Monitors staff productivity and accuracy to ensure requirements are met.
• Reviews bill hold reports for physician queries and contacts physicians who are not responding.
• Provides training and education to staff in the use of coding guidelines and practices, proper documentation techniques, medical terminology and disease processes, appropriate to the job description.
• Participates with the coding validators, communicates to staff any coding updates.
• Ensures external coding staff (agency coders) understands and agrees to adhere to the organization’s coding and policies, when applicable.
• Serves as a resource to department staff and other health care professionals in need of coding assistance, responding to questions.
• Researches complex coding issues, finds solutions and updates staff and practices as needed.
• Performs coding validation for outpatients as required; may be required to perform coding in instances of staff shortages.
• Supervises outpatient coders as required.
• Maintains knowledge of current professional coding certification requirements.
• Ensures staff is thoroughly trained in usage of ICD‑10 and/or CPT coding procedures in order to optimize reimbursement to Brown University Health for its services.
• Maintains knowledge of current payor policies and procedures including medical necessity and stays up to date with CMS and all third‑party regulations.
• Ensures effective recruitment, selection, development and evaluation of coding and clerical staff to optimize achievement of goals and objectives.
• Prepares payroll, submits work…