Supervisor, Outpatient Coding

System - Specialty Physician Revenue Cycle

Medical coding is bound by a complex set of rules and regulations: the Coding Supervisor must have extensive knowledge of ICD-10-CM diagnosis coding guidelines, CPT codes and modifier rules, including HCPCS codes, and Pro-fee coding guidelines. Responsible for monitoring coding workflow to assist with staffing to ensure productivity and quality goals are met. Collaborate with Billing Supervisor to solve cross departmental issues.

Provide coding guidance, as well as research complex coding and departmental issues and serve as a link to upper management. Must have and maintain AAPC or AHIMA credentials (CPC or CCS), mentor new coders and support co-worker development. Work closely with the Coding Manager during new hire processes, performance evaluations and assist with performance improvement plans for co-workers as needed.

Must be able to apply policies and procedures to solve every day problems and deal with a variety of situations and personalities.

Associates of Health Information Administration - Preferred

3-5 Years Coding and Revenue Cycle Management - Required

Proficient in use of spreadsheets and skilled in gathering, analyzing and evaluating data to uncover aberrant patterns of coding and billing. Must have knowledge of Revenue Cycle processes, specifically the workflow from clinical charge entry to coding through billing and denials. Written and verbal communication skills, time management skills, and proven ability to reach across departments to problem solve.

National Certification - Required

AAPC, CPC, AHIMA, CCS or RHIT

• Monitors workflow and daily unbilled reports to determine if turnaround time is within goal. Prepares a goal status spreadsheet daily and distributes to co-coworkers. Provides coding guidance to co-workers when needed.
• Resolves technical and personal issues timely. Promotes cooperation and team work. Monitors co-workers activity to ensure production standards are met daily.
• Participates in the training and orientation process for new staff as appropriate. Demonstrates initiative and flexibility. Participates in process improvement initiatives.
• Audits medical records to ensure proper coding completed and to ensure compliance with federal and state regulatory agencies. Evaluates medical records for documentation consistency and adequacy.
• Assigns diagnosis and procedure codes to complex outpatient encounters according to coding rules and regulatory requirements. Uses encoder to invoke national correct coding and outpatient code edits; appropriately appends modifiers to resolve edits.

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