Supervisor - Coding Compliance - Medical Coding

Coding Compliance provides professional services: auditing, training, consultation, audit and feedback to clinicians on their documentation and coding to ensure VC receives appropriate reimbursement and conforms to applicable guidelines and regulations.

Advocates compliance with all third-party billing and reimbursement requirements including, but not limited to, the requirements of Medicare and Medicaid programs.

Serves as the coding subject matter expert for the physicians.

Current CCS or CPC certification or equivalent required.

Must be a resident of Washington or Oregon.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES:


* Supervise and coordinate all activities of Coding compliance and auditors


* Lead or participate in cross-functional workgroups/committees as needed to represent coding compliance.


* Develop reports and presentations on projects for senior management


* Understand Medicare billing rules (i.e.

LCD/NCD, CCI, Medical Necessity, and ABN) and communicate this information to staff, management and physicians


* Stay abreast of current changes in coding and reimbursement requirements for government programs and other third-party payers


* Conduct system testing, provide feedback, and support conversions/implementations on coding and charge entry issues


* Actively participates in meetings and/or seminars and disseminates the information to peers to enhance the knowledge and skills of the department


* Performs audits utilizing an in-depth knowledge of ICD-10, CPT and HCPCS coding, Correct Coding Initiatives (CCI) and documentation guidelines.


* Provides training for all New and Established clinicians to ensure correct documentation and coding of procedures and diagnoses.


* Performs coding reviews for providers based on areas of deficiency and to support CMS required annual audits.


* Utilizes understanding of Practice Management system to recommend Master File changes to facilitate correct claims coding per carrier specifications.


* Monitoring of Clinical Coders' coding knowledge via audits and other mechanisms.

SKILLS AND ABILITIES:


* Leadership and supervisory skills.


* Knowledge of medical terminology and anatomy and ancillary tests/procedures.


* Excellent organizational skills and strong attention to detail required.


* Strong oral presentation skills.


* Must have demonstrated competence with computer systems including electronic health records, Microsoft Office Suite required.


* Typing skill of 40 wpm.


* Working knowledge of ICD-9, ICD-10, CPT, and HCPCS coding and Correct Coding Initiatives (CCI)


* Ability to train and audit new and established providers as skills are mastered.

SUPERVISORY RESPONSIBILITIES:


* Will supervise Compliance and Coding staff.

EDUCATION AND EXPERIENCE:


* High school diploma or equivalent required.


* Current CCS or CPC certification or equivalent required.


* At least two years of CPT, ICD-9 ...