Coding & Reimbursement Supervisor

PRIMARY PURPOSE

The Coding Supervisor is responsible for overseeing the performance of lead and medical coders (Hem/Onc, High Cost Drugs, Infusion,OB, MFM, Infectious Disease, and Ophthalmology) and ensuring adherence of all department and company policies and procedures. The supervisor assists with hiring, training, assigning work, and performance management of staff. This position requires occasional travel to provide on-site coding education to the providers and clinical staff and assistance with special projects as needed. The Supervisor is responsible for daily review and proper assignment of International Statistical Classification of Diseases and Related Health Problems (ICD-10-CM), Current Procedural Terminology (CPT), modifiers, and Healthcare Common Procedure Coding System (HCPCS) codes to inpatient, outpatient, surgical procedures and evaluation and management services.

Specialities include:
Lab
Cardiology
Diagnostic Imaging
PT/OT
Oncology
Medicare Advantage
Infusion

MAJOR RESPONSIBILITIES

• Ensures that medical coders are trained, knowledgeable and consistently adhering to key responsibilities relevant to job description
• Training new employees
• Perform ongoing training and education as needed
• Conduct billing audits to ensure the accuracy of the coding team and re-train and/or initiate coaching if necessary
• Monitor daily workload to ensure that charges are coming over in a timely manner
• Ensure that manual charges are coming through Billing Support and AlertMD on a daily basis without interruption
• Ensure that all WQ charges are flowing into the WQ'S daily without interruption
• Responsible for alerting proper parties if any interruptions are discovered
• Analyze hospital and office progress notes, procedural and operative records to identify and independently assign accurate ICD and CPT/HCPCS codes while adhering to ICD-10-CM, CPT and all appropriate government coding guidelines, in addition to adhering to all Boncura/DMG coding/billing policies and procedures.
• Resolve Pre-AR edits in practice management system by applying the aforementioned rules, policies and procedures.
• Abstracts pertinent information into the billing system accurately and timely.
• Maintains compliance with Federal, State and Payer regulations.
• Serves as a subject matter expert (SME) to Coding Shared Services team and clinicians as needed.
• Keeps abreast of current coding changes, documentation requirements and payer policies within designated specialty.
• Demonstrates the ability to educate/train coding staff, physicians and nurses as needed.
• Assist with coding denials received from payers.
• Identify denial trends and educate coding team and/or request system edits as needed
• Assist with charge capture initiatives by monitoring services performed to assure all encounters are captured (DAR reports, charge capture reports, etc.), coded and billed within timeframes established by Boncura.
• Monitor all WQ'S to ensure that charges are being worked in a timely fashion and alert management team as needed if any concerns are identified.
• Monitor Alert MD to ensure all charges are captured and reports are worked.
• Attends meetings and training by traveling to provider and business locations as needed.
• Handles human resource functions are it relations to:
• Processing payroll
• Reviews and approves time off requests
• Performs annual introductory and annual performance appraisals for your assigned team

SUPERVISORY/MANAGEMENT SCOPE

• Direct reports include front line staff of 5 - 15 FTE

MINIMUM EDUCATION AND EXPERIENCE REQUIRED

License / Registration / Certification

• Must be certified in at least 1 of the following: Certified Professional Coder (CPC) certification, Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS).

Issued by (Governing Body)

• AAPC
• AHIMA
• Accredited Program

• High School diploma required
• Associate's degree preferred, or 2 years experience equivalent

Field of Study

• Business, healthcare, or related field

Years of Experience

• Minimum 7 years experience in healthcare coding and billing

Describe Type of Experience

• Experience in multi-specialty physician coding or expert in single specialty physician coding required.
• Minimum of 3 years leadership experience