Supervisor of Coding

Position Purpose

This position is responsible for the organizational and functional integrity of the coding sections, ensuring staff compliance, development, and education. The incumbent is well-versed in Facility or Professional coding concepts, coordinates HIM initiatives to ensure accurate reimbursement in the Revenue Cycle, monitors productivity, and performs retrospective reviews for coding accuracy and educational opportunities. Focus is specific to hospital inpatient, outpatient, transitional care services or professional services.

Nature and Scope

Incumbent is responsible for the day-to-day operations of their coding team, ensuring adequate staffing, fair work distribution, and timely and accurate completion of coding tasks. They are responsible for coordinating work schedules, maintaining a calendar of scheduled time off for all employed coding staff and liaising with contract services when applicable to provide adequate coverage based on work volumes and required staffing plan adjustments.

The incumbent reviews and analyzes health records to identify relevant diagnoses and procedures for distinct patient encounters, translating diagnostic and therapeutic phrases utilized by healthcare providers into coded form. The translation process may require interaction with the healthcare provider to ensure that the terms have been translated correctly. The coded information that is a product of the coding process is then utilized for reimbursement purposes, in the assessment of clinical care, to support medical research activity, and to support the identification of healthcare concerns critical to the public at large.

Incumbent must have a thorough understanding of the content of the medical record in order to be able to locate information to support or provide specificity for coding. Incumbent must be trained in the anatomy and physiology of the human body and disease processes in order to understand the etiology, pathology, symptoms, signs, diagnostic studies, treatment modalities, and prognosis of diseases and procedures to be coded and to provide direction and mentoring of staff to ensure their understanding of coding principles and correct coding initiatives.

This position is challenged to be aware of the continual changes in Federal and State regulations for prospective payment, respond appropriately to observed fraud or abuse and keep informed of changes in treatment modalities and new procedures, and to perform appropriate queries when physician documentation is vague or missing. The Supervisor is expected to share pertinent changes with staff and to assist subordinates in interpretation and application of these changes.

The incumbent will be familiar with computer operations, encoder software, and electronic health record (HER) software. They must be capable of training others in data entry and abstracting. Incumbent will audit/approve time and attendance bi-weekly and monitor staff compliance with Renown Health policies. Incumbent will also monitor staff productivity weekly. Completes employee evaluations and 90 and 180-day progress reports timely, offering developmental plans pertinent to the position and employee growth.

Supervisor of Coding (Professional Services Focus): The incumbent that oversees Professional Services coders should demonstrate experience with ICD-10-CM, CPT, HCPCS, E/M and HCC capture. This incumbent will be responsible for monitoring work queue volumes, productivity and quality of coding for Professional Services coders. They will provide reporting on provider education results for multiple audiences, and develop the Professional Coding staff. This person assesses and maintains impact of current compliance activities and evaluates risk factors of coding and documentation practices. In addition to supervising staff and provider/physician CPT coding, they are expected to have a close working relationship with the Medical Directors and Operations Mangers to support provider coding accuracy that is consistent with industry standards and in compliance coding guidelines.

Supervisor of Coding (Facility Services Focus): The incumbent that oversees Coding Reimbursement Specialists should demonstrate experience with ICD-10-CM, ICD-10-PCS, CPT, DRGs and APCs. This incumbent will be responsible for monitoring work queue volumes, productivity and quality for Coding Reimbursement Specialists in order to reach our weekly DNFC goal. They will be tasked with identifying documentation improvement opportunities, risk factors, trends and business opportunities and develop recommendations. The incumbent should have the ability to speak and present Facility Coding concepts to for multiple audiences. They are expected to have a close working relationship with Clinical Documentation Improvement (CDI) and Medical Directors to support appropriate provider documentation, organization-wide quality initiatives, and proper facility coding practices in compliance with coding guidelines.

Supervisor of Coding (Single Path Focus): The incumbent will be responsible for supervising a specialized team of coders that can perform Single Path Coding (SPC) for both professional and facility services. The incumbent should demonstrate experience with ICD-10-CM, ICD-10-PCS, CPT, HCPCS, DRGs, APCs, E/M and HCC capture. They will monitor work queue volumes, productivity, and quality for SPC staff. They will be responsible for liaising and effectively communicating with Revenue Cycle staff and providers/physicians to assist with any inquiries or escalations related to SPC. They will be expected to work in conjunction with Professional and Facility Coding Supervisors to provide documentation improvement suggestions, presenting coding findings to multiple audiences and ensuring coders are in compliance with coding guidelines.

This position does not provide patient care.

Disclaimer

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

Minimum Qualifications

Requirements - Required and/or Preferred