As assigned by the manager/director, leads, manages and/or participates in coding integrity related projects, including but not limited to specialty specific coding education (1) audits. (2) research (3) education and (4) financial analysis. The incumbent is responsible for all related management aspects of the project, and provide education to the executive leadership team and physicians. Responsible for ensuring that project related training and quality assurance requirements are assessed and implemented by either overseeing activities or performing activities themselves.
This incumbent will assist the physicians, coders, and leadership team with accurate code assignment, develop methods to provide oversight and ongoing compliance, educate physicians on policy changes or coding/documentation opportunities, work, educate billing staff across all regions on policy changes, and assist HIM/Coding Management team in all functions In relation to coding compliance.
Responsible for the oversight of all coding consulting projects such that results provide timely and accurate recommendations consistent with the management decisions under consideration. In conjunction with coding leadership, this incumbent supervises, coaches, evaluates and counsels employees to ensure competency in all aspects of job duties, including regulatory compliance with CMS or other coding guidelines.
Demonstrates actions consistent with Ochsner's Expectations as duties are performed on a daily basis.
Coding certification required (CPC, CPC-H, CCS-P, CCS). Bachelor's degree in a related field preferred. Minimum five years of related healthcare experience required. Bachelor degree may be substituted for two years of experience. Clinical (nursing or allied health) or Coding background with Medicare and Managed Care reimbursement, Managed Care contractual arrangements and patient accounting billing background.
1. Strong leadership and communication skills. Must be able to prepare and present findings and results to diverse audiences; inducing Physicians, Vice Presidents, Compliance Officer, Attorneys, Directors, Managers and staff. Must be able to plan, coordinate and review projects involving complex business and technical matters.
2. Self-directed with strong analytical and operational problem solving skills.
3. Time management skills should include the ability to prioritize, organize and coordinate multiple work areas and assignments under fast paced and changing conditions to meet deadlines. Ability to resolve issues at lowest level and understands when to escalate or change priorities. Must be able to balance technical and practical needs.
4. Demonstrates competence in applying accounting principles and/or federal and state regulations to daily decision making process.
5. PC skills required in MS Office. Excel, PowerPoint and Access (or equivalent).
8. Positive attitude and the ability lo promote a cooperative and pleasant work environment since all responsibilities are team oriented.