Manager, Hospital-Professional Fee Coding in Oakland , California at Alameda Health System

SUMMARY: Manages the functions of Professional Fee and Hospital Coding, including daily oversight of coding staff. This role will ensure accuracy, consistency, and efficiency in relation to code assignment for reimbursement and reporting purposes.

DUTIES & ESSENTIAL JOB FUNCTIONS: NOTE: The following are the duties performed by employees in this classification. However, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification.

1. Communicating with physicians and health care professionals including CDI (Clinical Documentation Improvement) on an ongoing basis to clarify supportive documentation for code assignment.

2. Ensures accurate reporting to and compiles, reviews, and analyzes data reports and other documentation for the California Department of Health Care Access and Information (HCAi)

3. Monitors governmental and insurance industry information for updates/changes to standard coding practices and procedures, including updating correct code assignments as required.

4. Ensures timely response to coding audits and appeals.

5. Performs standard supervisory functions, including recruitment, hiring, on-boarding, training, coaching, mentoring, task assignment, performance evaluation, progressive discipline, conflict resolution and allocating staff resources.

6. Provides daily oversight and supervision of the coding staff, including outsourced vendor coders.

7. Performs quality reviews for coding staff in order to validate code and reimbursement assignments.

8. Serves on a variety of committees and attends professional meetings.

9. Training coding staff, providing educational seminars for health care staff.

10. Working with the Registration, Billing, Revenue Integrity, and Quality departments ensures accuracy, consistency, and efficiency in relation to the visit and code assignment for reimbursement and reporting purposes.

11. Performs related duties as assigned.

Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.

MINIMUM QUALIFICATIONS:

Preferred Education: Bachelor’s degree in related field

Required Education: Associate or Bachelor of Science degree in business, healthcare, or related field.

Minimum Experience: Five years coding experience within a healthcare environment, including chart audit and ProFee; three years supervisory experience in a Professional Coding Environment or an Acute care hospital setting with an EHR.

Required Licenses/Certifications: Certified Coding Specialist (CCS), Certified Coding Specialist-Professional (CCS-P) or Certified Professional Coder (CPC).

Required Licenses/Certifications: Certified Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA).