Coding Manager

Description

St. Croix Health is looking for a full-time (1.0FTE) Coding Manager to join our team. This position would work Monday-Friday, regular business hours. 

Job Summary: 

The Coding Manager is responsible for managing the coding functions for all hospital and professional services. The Coding Manager is responsible for planning, implementing, and educating coding staff, physicians, nurses and other departments to ensure coding quality and timely reimbursement. 

Essential Duties and Responsibilities: 

1.Operational Accountability

1.1. Provides direction and manages the day-to-day function within the coding department

1.2. Manages staffing plans and work assignments to achieve and 

1.3. Supervises coding staff

1.4. Manages, supervises, and monitors daily work activities, work lists, evaluates, trains, and motivates the performance of staff

1.5. Monitors coding work lists, unbilled accounts, aging of accounts to ensure timely filing of claims, and monitors coding workflows

1.6. Assists in department budget and identifies and recommends opportunities to decrease cost and improve services

1.7. Establishes and monitors the quality of the departments aligned with coding to support accurate patient information, compliant coding aligned with billing regulations and minimized corrections and re-work

2.Manages oversight for maintaining the CDM and charge capture processes

2.1. Monitors and maintains departmental chargemasters to ensure coding and billing accuracy of new and existing service codes

2.2. Works with clinical directors and managers to implement and monitor Charge Description Master (CDM) changes

2.3. Evaluates department requests to ensure that all additions, changes and deletions are consistent with proper charging coding practices

2.4. Develops reports to monitor compliance with department recommendations

2.5. Assists the Billing department in resolving third party payor billing issues

2.6. Provides analytical support related to reimbursement and billing

2.7. Acts as a liaison between multiple departments to help resolve billing edits that prevent claims from billing timely

3.Provider & Departmental education and communication

3.1.  Educate and train coding staff, acts as a professional subject matter expert and mentor to staff

3.2. Manage, train and educate staff as it pertains to denials in coding/ reviewing, coordinating, and monitoring the denial management and appeals process in a collaborative environment with CBO management and partners at various facilities. 

3.3. Promotes recruitment and retention of certified coding staff in coding positions

3.4. Select and develop qualified staff to perform the coding functions by providing guidance and counseling to improve employee performance; takes the appropriate disciplinary actions as needed

3.5. Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as a preceptor, mentor and resource to less experienced staff

4.Acts as a resource to answer coding questions and helps to ensure that department complies with standards

4.1. Enforces coding policies and procedures, conducts trend analysis to identify pattern and variations in coding department

4.2. Adheres to all St Croix Health policies, procedures, and standards within budgetary specifications including time management, supply management, productivity, and quality of service

4.3. Keeps abreast of new technology in coding and coding guidelines, stays informed about future issues impacting the coding functions, and acts as a liaison for other departments regarding coding questions. 

Requirements

Education & Licensure: 

• Bachelor's degree in related area is preferred
• Certification      through AHIMA as RHIA (Registered Health Information Administrator) or CCS (Certified Coding Specialist) or CCS-P (Certified Coding Specialist-Physician based) or certification through AAPC as CPC (Certified Professional Coder) or COC (Certified Outpatient Coder) or CIC (Certified Inpatient Coder). 

Experience:

• Minimum of five (5) years of coding in physician and/or hospital healthcare organization required
• Three (3) years supervisory/management progressive leadership experience required
• Knowledge of Coding/Billing regulatory requirements
• Epic and/or Excellian experience preferred

Knowledge, Skills & Abilities: 

• Knowledge of Coding/Billing regulatory requirements
• Effective oral and written communication skills
• Demonstrated effective leadership skills
• Ability to deal with difficult people and stressful situations in a professional manner
• Ability to review and analyze data with a high level of accuracy

Supervisory Responsibilities:

Oversee Coding staff including scheduling, timecard review, identifying developmental & training needs, navigating performance concerns and other relevant employee relations functions.

Physical Requirements:

• Prolonged periods of sitting at a desk and working on a computer
• Prolonged periods of standing, bending, and reaching
• Must be able to lift up to 15 pounds at times

St. Croix Health is an Equal Opportunity Employer.

St. Croix Health has been a healing force in the St. Croix Valley for over 103 years. We are a purpose-driven organization with a dedicated team committed to serving our patients and communities throughout the St. Croix Valley. This commitment is rooted in our mission, vision and values. 

Mission 

We help people live healthier, happier, and longer lives.              

Vision 

To transform from quality sick care to quality well care that is sustainable and affordable. 

Values 

People Centered, Trust, Innovation, and Growth. 

Here at St. Croix Health we offer our employees with a robust benefits package that includes: 

• Health, vision and dental insurance
• 403b retirement program with employer match
• Paid time off
• Short-term disability, long-term disability and life insurance options
• Education reimbursement
• Employee assistance program (EAP)
• Wellbeing incentive program
• Free parking
• Employee prescription discount program

St. Croix Health is a not-for-profit healthcare system located in St. Croix Falls, WI dedicated to helping people live healthier, happier, and longer lives. St. Croix Health offers the services of 80+ providers and 20 specialties with five community clinics in Minnesota and Wisconsin all supported by a critical access hospital on the main campus in St. Croix Falls, just an hour northeast of Minneapolis/St. Paul. Nestled in the bluffs of the St. Croix River Valley, St. Croix Falls is the ideal place to work, live and play.