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Professional Fee Coding Manager
Work Setting: Other
Job Function: Coding Supervisor/Manager
Job Type: Full-Time
**Xtend offers competitive benefits including; Medical/Dental/Vision, Generous Paid Time Off/Paid Holidays/Monthly Bonus Eligibility/Tuition Reimbursement/401k plan plus Employer Match/Professional Development***
Xtend Healthcare, a Navient company, is nationally recognized as the industry-leading provider of comprehensive revenue cycle solutions to hospitals and health systems. Sustaining healthcare revenue cycle improvement is our exclusive focus with experience in all 50 states and more than 30 years of dedicated health revenue cycle experience. We are committed to delivering solutions built around the broad revenue cycle needs of our clients.
Xtend Healthcare focuses on both clinical and financial interoperability to maximize collection of net revenue. Xtend Healthcare provides an array of solutions for our customers including full and partial revenue cycle outsourcing, third-party insurance follow-up, self-pay, coding, CDI, and consulting services.
THIS POSITION WILL BE REMOTE AND ON-SITE AT MT SINAI MEMORIAL HOSPITAL IN CHICAGO, IL. MUST RESIDE IN CLOSE PROXMIATEY TO LOCATION.
Xtend Healthcare is looking for a Professional Fee Coding Manager who will be responsible for leading a team of coders for five to ten projects that provides hospital and physician (provider) coding and auditing. Must have the ability to accurately audit and code (ICD-10-CM, ICD-10-PCS, CPT, HCPCS, Level I & II modifiers) all of the following service types: facility inpatient, emergency room, outpatient surgery, observation, ancillary, recurring therapy, clinic, professional, and billing/coding edit resolution. Will be working with multiple facility specific, state billing and coding guidelines as well as various Medicare Administrative Contractors nation-wide.
1. Personnel Management:
- Hiring, orientation, and training coders.
- Leading coding auditors on completion of daily work tasks.
- Evaluating performance and carrying out improvement activities.
2. Project Work:
- Reviews staff audit reports and summaries to ensure appropriateness.
- Professional or Facility coding.
- Acts as a back up to coding staff for clients as needed.
3. Record Keeping:
- Completion of staff productivity and scoring.
- Completion of Time Allocation reports daily and bi-weekly.
- Completion of Masterlog of accounts coded daily.
- Identifies trends and reports to Coding director.
- Identifies educational webinars/documentation for staff.
- Identifies staff who do not meet productivity of 85% weekly.
5. Customer Service:
- Client liaison to communicate account inquiries.
- Client liaison to report accuracy to clients as requested.
- High school diploma
- Ten or more years of experience with coding in a health care revenue cycle. This should include hospital and physician practice. (additional equivalent education above the required minimum may substitute for the required level of experience)
- An understanding of healthcare billing practices and compliant claims preparation for both governmental and commercial payers.
- Revenue Cycle Certifications: The following are recognized professional certifications: Certified Professional Account Representative (CPAR), Certified Revenue Cycle Representative (CRCR) or Certified Professional Biller (CPB).
- Electronic health record (EHR) expertise, including knowledge of a variety of vendors.
- Specialty Coding Certifications: The following are recognized professional certifications: Ambulatory Surgical Center (CASCC), Anesthesia and Pain Management (CANPC), Cardiology (CCC), Cardiovascular and Thoracic Surgery (CCVTC), Chiropractic (CCPC), Dermatology (CPCD), Emergency Department (CEDC), Evaluation and Management (CEMC), Family Practice (CFPC), Gastroenterology (CGIC), General Surgery (CGSC), Hematology and Oncology (CHONC), Internal Medicine (CIMC), Interventional Radiology and Cardiovascular (CIRRC), Obstetrics Gynecology (COBGC), Orthopaedic Surgery (COSC), Otolaryngology (CENTC), Pediatrics (CPEDC), Plastics and Reconstructive Surgery (CPRC), Rheumatology (CRHC), Surgical Foot & Ankle (CSFAC), and Urology (CUC).
- Coding Certifications: The following are recognized professional certifications: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Coding Associate (CCA); Certified Professional Coder (CPC); Certified Outpatient Coder (COC); Certified Inpatient Coder (CIC); Certified Coding Specialist (CCS); or Certified Coding Specialist – Physician (CCS-P); Certified Professional Medical Auditor (CPMA). Coding Auditor III team members are required to possess at least one of the above professional services coding certifications.
- Continuing Education Requirements: Medical coders shall maintain the required continuing education hours in order to maintain current and proper national certification(s) requirements for this position.
- Coding Test. Pass a pre-employment coding test that is provided, developed and administered by candidate management instructions, with a score of 80% or higher.
- Complete working knowledge and understanding of the full revenue cycle.
- Responsible for analyzing, reviewing and resolving coding and documentation issues that are related to reimbursement, compliance and revenue enhancement for each client.
- Responsible for reporting to the Director the coding statuses per client and type of service daily prior to 10am CST.
- Directs all coding functions for each client including: Work volume, daily DNFB management, error resolution and feedback to client.
- Responsible for reporting to Director for each of the clients and each type of service the productivity of coding staff on a monthly basis.
- Acts as a Client Liaison to each project for questions, meetings, etc. Significant customer interface responsibilities with hospital employees, physicians, mid-level providers, nursing, clinical, IS, patient financial services and registration.
- Responsible for employee time management, maintaining employee daily time sheets per pay period per month, time allocations per project, reviewing and approving PTO requests; making sure the clients are covered during PTO dates.
- Responsible for team member annual evaluations and career tracking.
- Works hand in hand with Auditing regarding educational needs for team members. Recommend improvements and corrections as identified.
- Holds team meetings and attends all departmental management meetings. Prepares reports for meeting presentations.
- Performs special projects for Director.
- Must possess a working knowledge of Medicare and Local Medical Review Policy Guidelines.
- Ability to function independently and as a team player in a fast-paced environment required.
- Knowledge of inpatient and DRG coding.
- Knowledge of computing observation hours.
- Knowledge of coding infusions and injections.
- Knowledge of surgical coding.
- Knowledge of Evaluation and Management coding.
- Must be able to maintain the company accuracy rating of 95%.
- Must meet set weekly quota for productivity.
- Knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM); Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT).
- Knowledge of reimbursement systems, including Prospective Payment System (PPS); Ambulatory Payment Classifications (APCs); and Resource-Based Relative Value Scale (RBRVS).
- Practical knowledge and understanding of industry nomenclature; medical and procedural terminology; anatomy and physiology; pharmacology; and disease processes.
- Practical knowledge of medical specialties; medical diagnostic and therapeutic procedures; ancillary services (includes, but is not limited to, Laboratory, Occupational Therapy, Physical Therapy, and Radiology).
High school diploma
Instructions for Resume Submission
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Posted: February 17, 2021 at 1:12 PM
Post ID: 58590