Asst Mgr, Physician Coding

Position Summary

Has a clear understanding of the professional revenue cycle in its entirety, and is responsible overseeing the physician coding team,

developing goals and objectives, and establishing policies and procedures for team operations, as well as ensuring proficiency, value and education related to professional coding guidelines.

Responsibilities

Oversees and monitors coding of physician inpatient and outpatient encounters within Orlando Health.

Assigns, prioritizes, and monitors respective staff workload.

Mentors and effectively coaches individual team members by addressing errors, performance issues, and trends identified through reporting.

Takes an active role in developing and presenting educational programs to physicians, physician extenders, and physician offices.

Responsible for productivity standards, performance evaluations, personnel issues and staff development, core competencies,

coaching plans and daily coaching for staff.

Prepare/distribute information summarizing opportunities with physician charge management on a monthly basis .

Determines whether services ordered by physicians and rendered to patients are accurately coded and billed, and supported by documentation in the clinical record through the auditing process.

Maintains current knowledge of all physician billing, clinical, and all related systems for the production of billing and documentation policies and processes.

Communicates cooperatively and constructively with physicians, physicians' office personnel, guests, patients, and members of the healthcare team.

Interacts with Health Information Management, Physician & Professional Services, Patient Accounting, Information Services (IS),

and other departments as necessary for appropriate follow-up.

Reviews accounts for compliance held in GECB Transaction Editing System (TES) as appropriate.

Requests additional diagnostic information on accounts from physicians' offices, ancillary areas, etc., as necessary to complete auditing functions.

Develop ad-hoc reports as needed to analyze data to identify trends and take appropriate steps to assist resolving coding issues that impact physician charges and revenue.

Possess proficient knowledge in Microsoft Office Word, Outlook, and PowerPoint, and moderate to expert knowledge with

Microsoft Excel due to high volumes of data management and organization.

Exceptional understanding of Orlando Health's EMR, PM, and charge management applications (Allscripts, GECB, GEMMS, Sunrise, Sovera, etc…).

Collects data and provides reports to management as designated.

• Maintains reasonably regular, punctual attendance consistent with policies, the ADA, FMLA and other federal, state and local standards.

• Maintains compliance with all policies and procedures.

Qualifications

Education/Training

Associate's degree required. Two (2) years of directly related work experience may substitute for the Associate's degree (in addition to the requirements listed in the Experience section).

Completion of medical coding certificate program.

Computer literacy, knowledge of Anatomy, Physiology and Medical Terminology required.

Thorough knowledge of official coding guidelines as per AMA, AHA, and CMS as evidenced by results of coding skills test of 90%

or better.

Proficient experience in Microsoft Word and Excel or similar computer software is required.

Licensure/Certification

Must maintain one (1) of the following national certifications:

Certified Professional Coder (CPC) through the American Academy of Professional Coders

Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P), Registered Health Information Administrator

(RHIA), Registered Health Information Technician (RHIT), Certified Tumor Registrar (CTR) through the American Health

Information Management Association (AHIMA)

Certified Medical Transcriptionist (CMT) through the Association for Healthcare Documentation Integrity (AHDI)

Experience

Four (4) years of medical coding experience within a physician practice or healthcare facility setting.

Working knowledge of Medicare, Medicaid, managed care and commercial insurance reimbursement policies.

Knowledge of CPT, HCPCS and ICD-9 and ICD-10 coding, and other third party billing rules, reimbursement, and coverage

guidelines. Demonstrated relationship-building skills in a managed healthcare environment.

Education/Training

Associate's degree required. Two (2) years of directly related work experience may substitute for the Associate's degree (in addition to the requirements listed in the Experience section).

Completion of medical coding certificate program.

Computer literacy, knowledge of Anatomy, Physiology and Medical Terminology required.

Thorough knowledge of official coding guidelines as per AMA, AHA, and CMS as evidenced by results of coding skills test of 90%

or better.

Proficient experience in Microsoft Word and Excel or similar computer software is required.

Licensure/Certification

Must maintain one (1) of the following national certifications:

Certified Professional Coder (CPC) through the American Academy of Professional Coders

Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P), Registered Health Information Administrator

(RHIA), Registered Health Information Technician (RHIT), Certified Tumor Registrar (CTR) through the American Health

Information Management Association (AHIMA)

Certified Medical Transcriptionist (CMT) through the Association for Healthcare Documentation Integrity (AHDI)

Experience

Four (4) years of medical coding experience within a physician practice or healthcare facility setting.

Working knowledge of Medicare, Medicaid, managed care and commercial insurance reimbursement policies.

Knowledge of CPT, HCPCS and ICD-9 and ICD-10 coding, and other third party billing rules, reimbursement, and coverage

guidelines. Demonstrated relationship-building skills in a managed healthcare environment.

Oversees and monitors coding of physician inpatient and outpatient encounters within Orlando Health.

Assigns, prioritizes, and monitors respective staff workload.

Mentors and effectively coaches individual team members by addressing errors, performance issues, and trends identified through reporting.

Takes an active role in developing and presenting educational programs to physicians, physician extenders, and physician offices.

Responsible for productivity standards, performance evaluations, personnel issues and staff development, core competencies,

coaching plans and daily coaching for staff.

Prepare/distribute information summarizing opportunities with physician charge management on a monthly basis .

Determines whether services ordered by physicians and rendered to patients are accurately coded and billed, and supported by documentation in the clinical record through the auditing process.

Maintains current knowledge of all physician billing, clinical, and all related systems for the production of billing and documentation policies and processes.

Communicates cooperatively and constructively with physicians, physicians' office personnel, guests, patients, and members of the healthcare team.

Interacts with Health Information Management, Physician & Professional Services, Patient Accounting, Information Services (IS),

and other departments as necessary for appropriate follow-up.

Reviews accounts for compliance held in GECB Transaction Editing System (TES) as appropriate.

Requests additional diagnostic information on accounts from physicians' offices, ancillary areas, etc., as necessary to complete auditing functions.

Develop ad-hoc reports as needed to analyze data to identify trends and take appropriate steps to assist resolving coding issues that impact physician charges and revenue.

Possess proficient knowledge in Microsoft Office Word, Outlook, and PowerPoint, and moderate to expert knowledge with

Microsoft Excel due to high volumes of data management and organization.

Exceptional understanding of Orlando Health's EMR, PM, and charge management applications (Allscripts, GECB, GEMMS, Sunrise, Sovera, etc…).

Collects data and provides reports to management as designated.

• Maintains reasonably regular, punctual attendance consistent with policies, the ADA, FMLA and other federal, state and local standards.

• Maintains compliance with all policies and procedures.