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HIM Coding Manager – Miami, FL
Health System Solutions (HSS)

Location: Miami, Florida
Work Setting: Hospital
Job Function:
Coding Supervisor/Manager
Job Type:


Responsible for high quality and efficient management of inpatient, outpatient surgery, and outpatient coding and reimbursement for all of our client’s facilities. Manages 7 A/R and ensures established goals, ICD9, ICD10, DRG, and CPT are met. Manages overall activities of personnel (in-house and remote coders) to ensure timeliness and compliance with CMS, OIG, and our client’s account receivable goals. Supervises up to 75 FTEs with an average annual volume of 768,056 accounts.

Job Description

  • Ensures timely and accurate collection of patient information for appropriate reimbursement, case mix index, DRG assignment, research, and education meeting health system goals.
  • Assesses current HIM coding compliance activities (POA, PACT, etc.) identifying areas of high risk and evaluating risk factors in coding, documentation practices and patient safety and assists with Fiscal Intermediary, RAC activities and other Perspective Payment retrospective reviews.
  • Reports and maintains formalized review process for outcome monitoring, coding compliance, and appropriate reimbursement and enforces policies and procedures pertaining to remote coders.
  • Monitors coding staff assignment and scheduling to provide efficient workflow and coverage of A/R functions as well as optimal utilization of available human resources and ensures accurate and timely completion of inpatient, outpatient surgery, and outpatient coding to meet accounts receivable goals to facilitate timely billing.
  • Ensures compliance with Medical Necessity of NCD and LCD guidelines for appropriate reimbursement monitoring failed accounts and reporting outcome of opportunities for improvement as well as compliance with APC and ASC grouping guidelines and modifier requirements for appropriate reimbursement.
  • Assists in selection and testing of software application upgrades, equipment, services, and supplies necessary for efficient and cost-effective operation of the department.
  • Selects, develops, counsels, evaluates, and rewards personnel to assure high level of quality, productivity, efficiency and job satisfactions in accordance to our client’s policies, procedures, and service standards.
  • Communicates timely and effectively with Director, Department Management staff, employees, Medical staff, and Ancillary departments.
  • Assists with development and implementation of standardized coding guidelines and documentation requirements in accordance with CMS and OIG guidelines and educates and prepares in-services providing decision support overview, demonstrations, and/or presentations for consistency and proper application of coding rules and regulations.
  • Reviews claim denials and rejections pertaining to coding identifying opportunities and developing action plan for prevention of similar denials and rejections from recurring.
  • Other duties as assigned.

Required Qualifications

Education / Qualifications/ Experience
  • Bachelor HIM Admin – BHIM
  • Certified Coding Specialist (CCS)
  • Seven (7) years of relevant work experience
  • Excellent leadership, verbal and written communication, problem-solving and personnel management skills.
  • Excellent computer proficiency (MS Office – Word, Excel and Outlook)
  • Must be able to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service
  • Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practices
  • Knowledgeable in DRG, MSDRGs, APC and ASC reimbursement methodologies, ICD9 CM/PCS, ICD10 CM/PCS and CPT4 coding conventions, health information systems, database management, spreadsheet design, and computer technology.
  • RHIT or RHIA (Preferred)
Physical & Mental Requirements
  • Constantly operates a computer and other office equipment to coordinate work.
  • Usually remains stationary for the majority of the day.
  • Frequently communicates with clients and coworkers and must be able to share information effectively.
  • Occasional stooping, reaching or kneeling may be necessary to reach into overhead or low cabinets.
  • Regularly uses close visual acuity and operates computer equipment to prepare and analyze and transmit data.
  • Works in an office environment

Health System Solutions is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information or any other basis protected by law, ordinance, or regulation

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Posted: November 13, 2019 at 11:18 AM
Post ID: 44926

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