Coding Supervisor

Admin Support Jackson Tennessee 10 - Day (United States of America) Responsible for initial and ongoing success of processes related to hospital coding including edit and denial resolution, staff education and training, and monitoring and audit of work performed by the Coding Specialists. Ensures optimal use of resources to achieve department goals for productivity and accuracy. Determines workflow priorities and effective methodologies to complete tasks. Serves as the immediate supervisor and coding authority for the Coding Specialists. Must have extensive knowledge of ICD-10-CM, ICD-10-PCS and CPT coding systems. Under the direct supervision of the Coding Manager, responsible for assigned 8-hour shift, 5 days a week. Employee is subject to call back and overtime as required by the hospital.

• Provides supervision and oversight for a high quality coding program and serves as an expert coding resource for the Coding Specialists.
• Performs Outpatient, Emergency Room (ER), OP Surgery, OP Observation and Inpatient audits on Coding Specialists, including assignment of ICD-10-CM codes, ICD-10-PCS codes, DRG's, Present on Admission indicators, CPT codes and Discharge status codes to ensure accuracy. Presents audit findings to the Compliance Department, Coding Manager and the Coding Specialists and develops education and training tools as needed.
• Provides ongoing training and education to Coding Specialists including new hires and existing staff for advancement. Monitors ongoing performance to ensure productivity and accuracy standards are met. Provides regular updates to Coding Manager regarding individual and team performance.
• Assesses and resolves coding and reimbursement related denials and edits to ensure timely submission of claims. Tracks edits and denials for trends and provides education and training as needed.
• Reviews and responds to external coding audits from payers and other outside sources. Refers cases for clinical review and potential appeal to a clinician when indicated. Communicates all external audit findings and resolutions to the Compliance Department.
• Supervises, coordinates and monitors daily workflow in the coding queues including unbilled accounts and coder productivity to help in maintaining financial expectations for the DNFB report.
• Assists in the development and maintenance of current coding policies and procedures and notifies management when revisions are needed.
• Works with Coding Specialists to resolve complex coding issues in a timely manner. Researches difficult coding topics and effectively communicates findings.
• Works collaboratively with the Clinical Documentation Improvement (CDI) Department to ensure complete and accurate documentation is available for coding and is in accordance with the Joint Commission and other mandated requirements. Works with CDI to establish consistency in optimal DRG assignment.
• Remains informed of continual changes in coding and billing and maintain compliance with federal, state and hospital policies.
• Strongly knowledgeable of the ICD-10 Official Guidelines for Coding and Reporting provided by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS) and the American Medical Association (AMA) CPT Coding Guidelines. Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association.
• Maintains routine communication with the coding staff to inform of department operational updates, coding updates and procedural changes.
• Communicates effectively with hospital departments, healthcare providers, and co-workers and responds to inquiries timely.
• Utilizes the physician query process when medical record documentation requires clarification for coding and billing purposes. Helps monitor accuracy of coder queries and response time from providers. Reports any issues with the query process to Management. Works with providers to complete queries in a timely manner.
• When indicated, performs coding of Inpatient, Outpatient, ER, OP Surgery, and OP Observation medical records utilizing available coding systems and adhering to productivity and accuracy standards.
• Utilizes online coding references, CMS Local Coverage Determinations (LCD's), and other payer guidelines to ensure accurate code assignment for compliance, billing and medical necessity.
• Abstracts established medical record data elements into current abstracting system including discharge dispositions and consulting and attending physicians.
• Works collaboratively with external reviewers and consultants to ensure efficient processes are in place for chart reviews.
• Responsible for coordinating requests for time off to ensure levels of staffing support established goals and maintains an up-to-date schedule for the coding area to reflect adequate staffing.
• Responsible for maintaining coding certification.
• Performs related responsibilities as required or directed.

• Skill and proficiency in diagnosis and procedure coding, and other principles, concepts and techniques of Health Information Management. Such proficiency is acquired through the completion of a Baccalaureate or Associate degree program in Health Information Management. An Associate's degree is required with a B.S. preferred. Certification as an RHIA, RHIT, or CCS is required.

• Current certification as RHIT, RHIA, or CCS by AHIMA.

• Knowledge of Health Information Management practices, coding and coding guidelines, as acquired through a minimum of 5 years experience in CPT and ICD-10 hospital coding. Supervisory or management experience preferred.

• Extensive knowledge of computer applications (Microsoft Windows, computerized equipment, etc,) a must. Experience with Cerner EMR and 3M 360 Computer Assisted Coding software required. Ability to navigate through the computer (software and hardware) and recognize potential issues.