Coding Operations, Senior Consultant (REMOTE, NATIONWIDE, U.S.)
The Senior Consultant, is responsible for providing expertise in the area of clinical coding practices and risk adjustment for both health plan and provider clients. The Senior Consultant will interface with operational and clinical leadership to assist in identification of operational and clinical best practices in maximizing recapture rates and appropriate coding. He/She will also coordinate implementation of programs designed to ensure all diagnosed codes and conditions are properly supported by appropriate documentation in the patient chart.
- Responsible for the daily operations of coding division including monitoring quality and quantity of workflow to ensure completion of work assignments.
- Serves as primary Coding department representative for resolution and improvement of revenue cycle initiatives/issues.
- Maintains understanding of assignment scope of work and manages performance within the agreed upon scope.
- Actively works and understands the DNFB/DNFC process. Delegates tasks and leads team in DNFB/DNFC activities to comply with organization and leading practice goals.
- Communicates with the Director of Health Information Management to support revenue cycle activities and key performance indicators.
- Assists in the development of coding and abstracting policies and practice standards and communicates all policy changes as requested.
- Oversees work assignments of system wide coding staff and adjusts work lists to accommodate volume and schedule changes.
- Identifies need for educational sessions in collaboration with audit team.
- Provides educational support and training of coding and documentation practices for all of coding and clinical staff.
- Hires, trains, counsels, disciplines and terminates coding staff (onsite and remote) when necessary
- Performs annual and introductory performance evaluations on staff.
- Provides cost effective management of resources.
- Authorizes and coordinates payroll.
- Assesses scanning/coding workflow processes, identifies innovative solutions when improvement is needed and initiates changes.
- Acts as a liaison to Clinical Documentation Improvement staff to facilitate documentation issues identified by coders.
- Acts as a liaison to physicians to facilitate any Physician Query questions.
- Reviews physician queries submitted by coders for leading or non-compliant language.
- Assists in developing new query forms as needed.
- Provides weekly reports to client and the Sr. Director of HIM Consulting.
- Interacts with billing office, physicians, IT, and hospital personnel to resolve coding/billing issues.
- Works on multiple IT platforms, including patient finance, encoders, as well as Precyse and client IT systems.
- Participates in the processing of RAC audits as well as all types of internal and external auditing.
- Stays abreast of the differences in payment processes amongst insurance payers.
- Possesses a solid grasp of the charge master, revenue codes, processing patient type changes, cancelled accounts, and working multiple edits.
- Maintains strict physician and patient confidentiality and follows state, federal and hospital guidelines for the release of information.
- Maintains current skill set with regard to government regulations, compliance and TJC and DNV guidelines.
- Keeps abreast of new legislation and regulations that affect HIM.
- Participates on all applicable committees and professional organizations and maintains personal and professional education and growth.
- Makes travel plans timely.
- Presents on the Precyse HIM Consulting call once per year on a relevant Industry or client topic.
- Identifies two additional Precyse opportunities per year.
- RHIT or RHIA. Must maintain credentials through completion of required CE requirements.
- Bachelor's Degree in Health Information Management or related field.
- 5+ years as a Coding Manager with oversight of coder performance within an Acute Care hospital.
- Candidate must be able to code and audit both inpatient and outpatient records.
- Experience with coding workflow redesign in Acute Care hospital facilities.
- Possesses a strong grasp of MS-DRGs, APCs, and ICD-10 coding requirements.
- Requires strong interpersonal skills to work with physicians and staff to implement positive change.
- Demonstrated customer-oriented management style.
- Demonstrates knowledge of computer technology and automated system designs for HIM; computer knowledge of MS Office including Word, Excel, and PowerPoint
- Demonstrated ability to speak clearly and concisely while presenting is preferred.
nThrive is the leader in providing end-to-end revenue cycle services, technology and education solutions. Previously known as MedAssets, Precyse and Equation, each formerly a leader in its own right, we've combined our talents and capabilities into a single enterprise. At nThrive, we are people who are passionate about empowering health care for every one in every community. We work together to transform financial and operational performance, enabling health care organizations to thrive.
Equal Opportunity Employer EOE M/F/D/V
Sat, 13 May 2017 06:59:56 PDT