Manager, Outpatient Coding (CPC or CCS) - Remote

Description

How have you impacted someone's life today? At Hackensack Meridian Health our teams are focused on changing the lives of our patients by providing the highest level of care each and every day. From our hospitals, rehab centers and occupational health teams to our long-term care centers and at-home care capabilities, our complete spectrum of services will allow you to apply your skills in multiple settings while building your career, all within New Jersey's premier healthcare system.

The Manager, Outpatient Coding ensures compliance with applicable documentation, coding, and billing regulations to ensure appropriate reimbursement and stays knowledgeable of all ICD9, CPT, and HCPCs coding changes and guidelines. This position manages and coordinates activities of the outpatient audit and coding staff in Health Information and ambulatory areas within Hackensack Meridian Health (HMH).

Responsibilties

As a Manager, Outpatient Coding at Hackensack Meridian Health, you will:

• Coordinates coding and reimbursement tasks for reduced days in accounts receivable to meet or exceed targeted goals.
• Responds to inquiries for coding and reimbursement from other departments, and identifies and resolves issues related to coding, denials, and appeals.
• Reviews APC assignment for Medicare/Medicaid and commercial patients for the purpose of reimbursement, research and statistics in compliance with Federal regulations according to ICD-9-CM, CPT-4, and HCPCS coding classification systems.
• Coordinates concurrent and retrospective quality audits at least quarterly to ensure compliance with regulatory agencies and reports findings to corporate compliance and other departments as appropriate.
• Provides and coordinates education sessions for coders and other Medical Center personnel who perform coding tasks.
• Collaborates with CDM Coordinator and outpatient managers to ensure the CDM and charge tickets/superbills are updated in a timely manner.
• Oversees the analysis of physician documentation in the medical records for coding compliance.
• Assists physicians' office managers with coding inquiries.
• Contacts physicians for clarification of documentation of final diagnoses for coding compliance and assists physicians' office managers with coding inquiries.
• Maintains and updates procedural workflows and departmental policies and procedures related to medical coding.
• Adheres to the standards identified in the Medical Center's Organizational and Managerial Competencies.
• Other duties and/or projects as assigned.

Qualifications

Education, Knowledge, Skills and Abilities Required:

• Bachelor Degree.
• Minimum of 5 years of experience and thorough knowledge of Case Mix Index, ICD-9-CM, CPT-4, HCPCS and APC methodologies.
• Experience and knowledge of DOH, JCAHO and CMS regulations.
• Experience interpreting LMRPs, billing forms and knowledge of CDM requirements.
• Experience with auditing for quality improvement.
• Proficient in computer skills.
• Excellent written and verbal communication skills.
• Proficient computer skills including but not limited to Microsoft Office and Google Suite platforms.

Education, Knowledge, Skills And Abilities Preferred

• Experience with physician reimbursement.

Licenses And Certifications Required

• Certified Coding Specialist (CCS/CCA) or Certified Professional Coder (CPC/COC) or candidate must attain said certification(s) within 6 months of hire

Licenses And Certifications Preferred

• Epic HIM Hospital Coding Certification.