Supervisor, HIM Coding Quality

Interested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission: the health and well-being of individuals and communities entrusted to our care. By joining Parkland, you become part of a diverse healthcare legacy that’s served our community for more than 125 years. Put your skills to work with us, seek opportunities to learn and join a talented team where patient care is more than a job. It’s our passion.

Primary Purpose

Supervises day-to-day operations with the Parkland coding editor team. Coordinates with all areas of Parkland HIM, Parkland Revenue Cycle, and Clinics to provide timely, completeness, and accuracy of coding which triggers edits for optimal reimbursement. Proactively identifies and resolves potential coding denials for trending and education. Monitors team production, and quality all while maintaining workflows to support efficiencies.  Must demonstrate the ability to provide direction to editors as it relates to coding integrity, established coding guidelines and Parkland's policies to ensure accuracy of recorded patient medical information and appropriate reimbursement for services rendered.

Minimum Specifications

Education

•             Must have a High School diploma or GED equivalent, OR

•             Must be a graduate of a Health Information Management program, OR

•             Must have successfully completed an approved coding program.

Experience

•             Must have ten (10) years of Coding/Health Information Management (HIM) experience.

Equivalent Education and/or Experience

•             May have an equivalent combination of education and/or experience in lieu of specific education and/or experience as stated above.

Certification/Registration/Licensure

Must have one of the following:

• Registered Health Information Administrator (RHIA)
• Registered Health Information Technician (RHIT)
• Certified Coding Specialist (CCS)
• Certified Coding Specialist-Physician (CCS-P)
•  

Skills or Special Abilities

•             Must possess strong supervisory, leadership, and interpersonal skills.

•             Must be able to demonstrate time management, organizational, oral, and written communication skills.

•             Must be proficient and demonstrate advanced knowledge of ICD-10-CM/PCS and CPT/HCPCS coding and abstracting and have advanced clinical knowledge of medical terminology, disease process, and pharmacology.

•             Must be able to demonstrate knowledge of reimbursement (Medicare and Medicaid) principles and methodologies (MS-DRG and APC).

•             Must have a working knowledge of compliance guidelines related to coding and billing.

•             Must have strong skills in diplomacy, professionalism, and trustworthiness.

•             Must be able to demonstrate excellent computer skills, including word processing, spreadsheet, and database management software proficiency.

•             Must be able to adjust to multiple demands, shifting priorities, ambiguity, and rapid change.

•             Must be able to build trust with others by demonstrating authenticity and follow-through on commitments.

•             Must be able to demonstrate critical thinking, time management, and organizational skills.

•             Must have strong skills in diplomacy, professionalism, and trustworthiness.

Responsibilities

1.            Assists in the selection of new team members, trains, schedules, motivates, supervises, and evaluates employees making recommendations for disciplinary actions up to and including termination, to ensure maximum utilization of individual and group capabilities. Ensures that assigned employees receive opportunities to further their knowledge.

2.            Responsible for ensuring the performance of quality assurance activities with designated service level agreements in place.

3.            Provides input into procedural changes in order to maintain efficient operation of the Coding Quality Review and Revenue Integrity process.

4.            Understands "official coding guidelines" as published in AHA Coding Clinic and AMA CPT Assistant, and hospital policy, including specific payer guidelines, rules, and regulations in analyzing questionable documentation to ensure the accuracy and completeness of clinical and financial information reported for billing of hospital services. Provides reports and feedback to the Coding Quality Manager on findings as needed.

5.            Maintains knowledge of applicable rules, regulations, policies, laws, and guidelines that impact the coding quality area. Provides input as requested to assist in the development of effective internal controls that promote adherence to applicable state/federal laws, and the program requirements of accreditation agencies and federal, state, and private health plans.

6.            Stays abreast of the latest developments, advancements, and trends in medical records coding by attending educational programs, reading professional journals, actively participating in professional organizations, and maintaining certification. Integrates knowledge gained into current work practices.

7.            Maintains a positive working relationship with physicians, nurses, medical staff, and hospital employees to ensure that all work-related encounters are productive.

8.            Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to the Coding Quality Manager and implements and monitors results as appropriate in support of the overall goals of the department and Parkland.

9.            Conducts training and integration of new staff to the Revenue Integrity and Quality Review department, as required.

10.          Maintains positive communication with various departments. Takes the lead on researching opportunities and presents options regarding how to resolve issues that impact the revenue cycle and operational processes. Notifies the Coding Quality Manager when trends and opportunities for improvement are discovered.

11.          Identifies opportunities for process improvement and assists in plan development to achieve process performance goals to improve effectiveness, productivity, and efficiency that support the overall goals of the department and Parkland.

Job Accountabilities

Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of the department and Parkland.

Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices.

Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seeks advice and guidance as needed to ensure proper understanding.

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Parkland Health and Hospital System prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status. As part of our commitment to our patients and employees’ wellness, Parkland Health is a tobacco and smoke-free campus.