Senior Medical Coder
Mpower Talent Solutions
San Antonio , TX 78216
Posted 2 months ago
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Responsible for planning, organizing, and directing the operation, training, quality, support services and administration of the Accurate Coding Initiative (ACI) department to ensure that the coding processes for record reviews are conducted in a timely manner to meet company and regulatory standards. The individual coordinates departmental duties with appropriate personnel to meet needs of the department, ensures compliance with state and federal requirements, CMS guidelines. Develops and implements policy and procedures; updates and integrates the medical management departments as able to improve efficiency; performs employee counseling, performance appraisals, and oversights employee training and development. The success of this position requires the ability to foster communication and teamwork between physicians, clinic staff, medical management staff, corporate departments, and senior leadership. The individual provides long-term planning and oversight to maintain operations of the department assuring activities are appropriately integrated into the strategic direction, as well as the mission and values of the company.
Minimum Required Education, Experience & Skills
- Bachelor's of Science in Nursing required.
- Current Registered Nurse (RN) licensure required.
- Five or more years of clinical RN experience with at least 3 years of ICD-9 diagnostic coding and supervisory experience required.
- Strong knowledge of ICD-9 coding processes with excellent analytical and data mining skills required.
- Ability to effectively manage projects, plan and implement programs and evaluate outcomes required.
- Ability to effectively report data, facts and recommendations in oral and/or written form required.
- Ability to analyze facts and exercise sound judgment when arriving at conclusions required.
- Ability to effectively manage and direct various levels of staff required.
Preferred Education, Experience & Skills
- Previous medical coding operations management experience preferred.
- Certified Professional Coder (CPC) certification preferred.
- Master's Degree in Nursing or related field preferred
- Provides day-to-day oversight of operations for the ACI department.
- Hires staff for all markets and assures adequate staffing is in place to meet market demands
- Maintains, revises and implements the medical record review processes and resource/reference tools.
- Coordinates educational training sessions for market Primary Care Physicians and their staff to ensure federal and regulatory compliance, as well as coding and documentation compliance.
- Provides monthly reports to senior management.
- Monitors staff compliance in regard to ACI departmental policies and procedures to ensure quality outcomes for the company.
- Monitors and maintains staff productivity and coordinates training for new and existing employees.
- Identifies process improvement opportunities for ACI team to ensure quality outcomes in ICD-9 coding and overall ACI process.
- Provides employee coaching, counseling and evaluation of performance through periodic and annual reviews.
- Develops training programs and coordinates training needs for ACI team, new employees and providers and other clinic staff as necessary.
- Assists IS/ DBA with new development and maintenance of the audit application and quality upgrades to the application on an ongoing basis to ensure efficiency in production for clinical coding staff.
- Assists IS/DBA and the Clinical Research departmental with data mining efforts in recruitment process for clinical research studies
- Develops and implements objective quality program that ensures compliance with CMS and ICD-9 coding requirements and administers the program in a professional, objective manner as well as ensuring inter rater reliability.
- Performs all other related duties as assigned.