Health Information Management, Outpatient Coding Manager, – FT, Days, – Remote

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Job Summary

Leads and manages the daily operations of Outpatient coding across multi-system facilities. Ensures accurate, timely and complete coding that reflects facility diagnoses and procedures for services provided in accordance with organization policies and procedures, coding guidelines, regulatory agencies and payer requirements. Responsible for leading and managing the daily operations of Emergency Department, Observation, Outpatient Surgery, and Outpatient clinic charging and coding across multi system facilities. Ensures accurate, timely and complete inpatient coding that reflects facility diagnoses and procedures for services provided in accordance with organization policies and procedures, coding guidelines, regulatory agencies and payor requirements. Works closely with the Revenue Cycle, Revenue Integrity, and clinical departments to ensure code and procedure assignment for optimal reimbursement.

Essential Functions

• Manages, organizes and prioritizes work to ensure medical records are coded accurately and in timeframes that will assure compliance with regulatory, coding guidelines and payer requirements. –
• Manage area human resources by, implementing and monitoring staffing plans, monitoring daily workload, providing direction through development plans and performance evaluations, managing projects and responsibilities in support of the department and organization vision, goals and standards of behavior.
• In partnership with Director of Coding, Revenue Cycle, Revenue Integrity and clinical departments, recommends and implements standardized, organized-wide coding guidelines and documentation requirements as well as collaborates to develop and implement training and educational programs for coders and clinical departments.
• Assists in the development and implementation of coding policies, procedures and standard operating procedures.
• Continuously assesses and improves the department’s performance by designing operational processes, monitoring performance through data, implementing sustainable performance improvement.
• Manages and resolves customer concerns and coding discrepancies; identifies and implements mitigation strategies and takes a proactive approach to resolving issues and addressing complaints.
• Stays up to date with external policies and regulations that affect coding from agencies such as Office of Inspector General (OIG), Centers for Medicare and Medicaid Services (CMS) and other payers; communicates changes and impact on the coding teams.
• Participates in the design, testing and implementation of computer systems affecting coding and documentation.
• Performs other duties as assigned.

Supervisory/Management Responsibilities

• Job has direct and/or indirect supervision of team members that may include final budget authority, hire/termination authority, performance appraisal responsibility and disciplinary authority. Job will be considered a member of management staff at Prisma Health or affiliate and will have direct reports.

Minimum Requirements

• Education – Associate Degree in Health Information Management. Bachelor’s Degree in Health Information Management preferred.
• Experience – 5 Years – Minimum of 5 years coding experience in acute care setting required. ED, Outpatient, Outpatient surgery and Observation and Charge Capture experience required. Minimum of 4 years leading teams or progressive management in Health Information Management of a multi-entity healthcare delivery organization required.

In Lieu Of

• In Lieu of the education and experience requirements noted above, the following combination of education, training and/or experience will be considered an equivalent substitution: 7 years of Outpatient coding with 4 years minimum of managing and leading coding teams. 

Required Certifications, Registrations, Licenses

• Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), or other approved coding credential.

Knowledge, Skills and Abilities

• Strong knowledge of International Classification of Diseases-10 (ICD-10).
• Knowledge of Clinical Documentation Improvement principles, Quality Indicators, formal and informal coding audit processes.
• Effective verbal and written communication and strong customer service skills.
• Excellent problem-solving and critical thinking skills.
• Ability to collect, maintain, analyze and report statistical and other data.
• Ability to work effectively, independently and manage multiple demands consistently.
• Ability to operate multiple Windows based software applications and experience with office software such as Excel and Word.
• Knowledge of office equipment (fax/copier).
• Proficient computer skills (word processing, spreadsheets, database).

Work Shift

Day (United States of America)

Location

Corporate

Facility

7001 Corporate

Department

70017512 HIM Coding

Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

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