• Coding Manager

    Location US-MA-Brookline
    Job Posted Date 5 months ago(5/30/2019 3:31 PM)
    Job ID
    2019-15405
    Category
    Finance/Accounting/Patient Billing
    Type
    full time
    Grade
    23
  • Overview

    Located in Boston and the surrounding communities, Dana-Farber Cancer Institute brings together world renowned clinicians, innovative researchers and dedicated professionals, allies in the common mission of conquering cancer, HIV/AIDS and related diseases. Combining extremely talented people with the best technologies in a genuinely positive environment, we provide compassionate and comprehensive care to patients of all ages; we conduct research that advances treatment; we educate tomorrow's physician/researchers; we reach out to underserved members of our community; and we work with amazing partners, including other Harvard Medical School-affiliated hospitals.

    The Coding Manager directs the coding and classification activities of the Coding Dept under the general direction of the Director of Patient Financial Services. This individual oversees the coding professionals that are responsible for accurately assigning diagnostic and procedural codes to outpatient accounts; resolves issues as it relates to the revenue cycle operations of the facility (i.e.) CDM updates in regard to revenue code and CPT/HCPCS assignment; develops and provides coding education for internal and external staff; supports the fiscal goals of DFCI by providing timely and accurate coding of unbilled accounts, resolution of denied and failed claims and enforcement of a compliant environment within revenue cycle operations.

    Responsibilities

    • Responsible for the selection, orientation, training, counseling and mentoring of coding staff. Closely monitors the work of new coding staff members to ensure the quality and quantity of a new employees work meets department's expectations. Schedules staff to ensure adequate coverage of the coding function. 
    • Develops and coordinates educational and training programs regarding elements of the coding compliance program, such as appropriate documentation and accurate coding, to appropriate personnel, including coding staff, physicians, billing personnel, and ancillary departments. The Coding Manager will effectively bridge clinical guidelines with applicable coding regulations as required and needed in the institution. Plans and teaches coding and billing programs at DFCI campus and satellite centers when appropriate. Produces training procedures and manuals as needed for provider and staff education, including, but not limited to, RN Infusion Coding training, Provider ICD-9CM training, ESA Coverage & Billing updates. Conducts coding departmental meetings per department policy. Schedules and maintains records on Coding seminars and audio seminars for staff CEU requirements.
    • Conducts regular audits and coordinates ongoing monitoring of coding accuracy to ensure it is consistent with local, federal and industry standards. Reviews for accuracy, a sample of at least 10 cases coded and abstracted by each coding staff member, quarterly. Prepares a report of findings and actions taken or planned Assists the Human Resources Department in identifying characteristics and expertise of potential coding candidates. Prepares evaluations of staff's performance.
    • Abides by the Standards of Ethic Coding as set forth and updated by AHIMA.
    • Responsible for development, implementation, monitoring, and maintenance of the coding compliance program that supports sound and compliant coding practices by employed and contracted coding personnel. 
    • Works collaboratively with physicians and other caregivers to obtain complete documentation to support the assignment of ICD-9 CM codes. Serves as the organizational expert related to the assignment of ICD-9cm and CPT-4 codes.
    • Effectively works with areas of revenue cycle operations. Ensures appropriate workflow to ensure unbilled accounts do not exceed bill lag day maximum
    • Responds to requests for reports, (i.e.) outstanding queries, denials due to coding, staff productivity, etc. in a timely manner. 
    • Works collaboratively with ancillary departments to implement new services or revise current practices. Makes recommendations to ensure that documentation, coding and physician orders meet the organization's standards and clinical practice guidelines. Performs periodic reviews of services for monitoring purposes.
    • Assists coders in identifying and correcting claims that have failed the coding edits. Assesses these claims to identify root cause and implement corrective action. Prepares compliance reports on any coding errors and actions taken; summarizes actions taken to avoid billing delays due to coding errors.
    • Provides feedback and focused educational programs on the results of coding compliance auditing and monitoring activities to affected staff and physicians.
    • Reviews claim denials and rejections pertaining to coding and medical necessity issues and, when necessary, implements corrective action plan to prevent similar denials and rejections from recurring. Assists Patient Accounting representatives in processing claims that have failed due to diagnosis and procedure code errors.
    • Reports issues detected through auditing and monitoring, nature of corrective action plans implemented in response to identified problems, and results of follow-up audits to the Director. Recommends disciplinary action for violation of the compliance program, the organizations' standards of conduct, or coding policies and procedures to the Director. Reports compliance related concerns in writing to the Director promptly.
    • Assists Administration in analyzing trends in diagnoses and conditions treated at the Hospital for Administration's planning purposes. 
    • Ensures the appropriate dissemination and communication of all regulation, policy, and guideline changes to affected personnel.
    • Serves as a resource for department managers, staff, physicians, and administration to obtain information or clarification on accurate and ethical coding and documentation standards, guidelines, and regulatory requirements.
    • Coordinates with various IT depts., such as PAIS, RCIS and other IS Application Managers on system updates for ICD-9CM and CPT- 4. 
    • Proficiently uses the various computer applications installed at DFCI, including, but not limited to : GE IDX , 3M, MedAptus, CITRIX .
    • Serves as a member on various DFCI workgroups and committees, as requested by the Director of Patient Financial Services.
    • Monitors spending for coding section activities within the Director's budget guidelines. Responsible for staff and resource planning for coding activities, and equipment evaluations and purchases including hardware and software, and identification and selection of educational programs and tools to maintain the skills of the coding staff. 
    • Performs other duties as indicated to achieve department goals and/or as requested.

    Qualifications

    • Bachelor's degree or equivalent required
    • RHIT or RHIA required
    • Minimum 5 years coding experience
    • CCS/CPC will be considered
    • General knowledge of coding process
    • Ability to train and oversee staff
    • Strong project/task management skills
    • Dependable self-starter, able to set priorities, manage multiple data 
    • needs, and meet deadlines
    • Strong interpersonal, oral, and written communication and
    • organizational skills
    • Ability to work well independently on a team and as a trainer/facilitator
    • Ability to analyze complex business problems and implement solutions
    • Experience with ICD-9 CM, CPT, and HCPCS codes
    • General understanding of encoder software programs (i.e.) 3M 



    Dana-Farber Cancer Institute is an equal opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other groups as protected by law.

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