Regional Coding Manager

Essential Job Functions

• Provides overall management and direction of coding and abstracting activities. Oversee all duties and responsibilities of the coding staff.

• Must understand and demonstrate skill with the use of all Microsoft Office Suite of products such as Microsoft Word, Excel, and PowerPoint

• Responds to Coding/Abstracting data and report requests made by Client, physicians, and other internal customers.

• Utilizes database queries and reports to perform various auditing functions. 

• Works with the Medical Staff and other departments for resolution and education of coding, documentation, and reimbursement issues. 

• Develops and provides oversight for internal and external coding validation programs in conjunction with established client programs.  Identifies cases, monitors timeliness of data collection, aggregates, analyzes, and trends data. Provides summary and individual feedback to coding staff for performance improvement and compliance purposes.  Reports validation findings to Client on a monthly basis and identifies area for clinical documentation improvement and coder education.

• Maintains a knowledge base of various payment methodologies, grouping classifications and ICD-10 CM and ICD-10 PCS, as well as ICD-9.

• Provides ongoing training and in-service programs for coding staff to support corporate compliance. 

• Prepares and updates policies and procedures for Coding/Abstracting section, including internal coding guidelines. 

• Oversees that month end coding activity is closed out for abstracting purposes within the established client timelines. 

• Prepares monthly management reports on section productivity and quality. 

• Completes performance reviews, recommend and/or initiate employee selection, promotion, disciplinary and/or discharge actions. 

• Coordinates coding staff meetings, keeps staff informed of HIMS and regulatory changes, developments, and events. 

• Provides leadership and expertise in the areas of coding, compliance, reimbursement, and reporting of coded data. Understands flow of health information in the electronic health record from registration through documentation, discharge, coding, and billing. Ensures compliance with OIG, CMS, state Medicaid third party payer, RAC and additional state and federal auditing contractor regulations regarding coding and data reporting.

• Assists with system analysis, implementation, testing, database management, maintenance, accuracy, regulatory compliance, troubleshooting, and security of coding/abstracting systems, interfaces, databases, and reporting tools for systems using coding/abstracting data (e.g., 3M, Compass/Allscripts, EPIC, etc.). 

• Works with Client and IT Analysts to develop products to improve performance, efficiency, and data integrity. 

• Abides by the Standards of Ethical coding set forth by AHIMA and monitors coding team for violations and reports as areas of concern are identified

• Assists in the preparation and monitoring of the operating budgets. 

• Prepares and completes weekly Omega solutions metrics report.

• Work with Omega solutions team to perform vetting on candidates to assure appropriate client assignment.

• Meet budgetary goals per client agreement and achieves margins determined by Omega solutions

• Meet all SLAs for client engagement.

• Oversees management of accounts receivables (DNFB) and manages staffing resources to accommodate daily patient volume within expected turn-around times and financial targets.

• Demonstrates the ability to attract, recognize, retain and manage staff and to effectively utilize staff to enhance the facilities and Omega solutions organizational performance.

• Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance.

Key Success Indicators/Attributes

• Ability to prioritize and multi-task in a fast-paced, changing environment.

• Demonstrate ability to work in all work types and specialties.

• Demonstrate ability to self-motivate, set goals, and meet deadlines.

• Demonstrate leadership, mentoring, and interpersonal skills.

• Demonstrate excellent presentation, verbal, and written communication skills.

• Ability to develop and maintain relationships with key business partners by building personal credibility and trust.

• Maintain courteous and professional working relationships with employees at all levels of the organization.

• Demonstrate excellent analytical, critical thinking and problem-solving skills.

• Skill in operating a personal computer and utilizing a variety of software applications.

• Critical thinking skills demonstrated by the ability to make key decisions at client sites and with the oversight of direct reports without on-going feedback or supervision from upper management

Supervisory Responsibility

Yes

Work Environment

This job operates in a remote home office environment. This role routinely uses standard office equipment such as computers and phones.

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.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; and talk or hear. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus.

Position Type/Expected Hours of Work 

This is a full-time position. Days and hours of work are generally Monday through Friday, 8:00 a.m. to 5 p.m. This position occasionally requires long hours and weekend work.

Travel

Minimal travel required; up to 5%

Required Education and Experience

• Bachelor’s Degree or a combination of advanced formal training within the discipline and Dual Credential with Certified Coding Specialist (CCS). 

• AHIMA certification as a RHIA, RHIT or CCS.

• 5+ years coding management experience in a facility setting. Pro fee experience nice to have but not necessary. Experience with managing an offshore model.

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Preferred Education and Experience

Project management experience is a plus.

Additional Eligibility Qualifications

N/A