Carle Health
Overview
The Health Information Management Coding Manager provides day-to-day oversight, direction and management for the hospital inpatient and hospital outpatient functions within the Carle Health system. The Coding Manager ensures the quality, accuracy and timeliness of all the coding completed within Health Information Management. The position is responsible for planning, analyzing and development of operations, procedures and processes with respect to coding. The role acts as a liaison and consultant for other departments with respect to coding and coding regulatory requirements. The coding manager is responsible for yearly cost center budgeting and advises the HIM Director in the area of coding, coding education, coding software, coding staffing and budgeting. The coding manager is responsible to ensure appropriate staffing for all areas coded by Health Information Management.
Responsibilities
Communicates effectively with internal and external customers. Identify and resolve issues regarding billing, reimbursement, coding, audits or case mix index. Conduct regular audits and ongoing monitoring of coding accuracy. Provide feedback and focused educational programs on audit results to affected physicians and organizational staff. Report coding quality and accuracy regularly according to HIM policy. Supervise and manage all inpatient and outpatient coding activities and staff for the Carle Health system. Directly assist and mentor clinical staff, administration, department managers and compliance staff regarding coding standards, guidelines and regulatory requirements. Ensure dissemination of regulatory or compliance guidelines and changes related to coding. Coordinate with Concurrent Clinical Documentation Specialists, inpatient/outpatient/physician coders, physician advisors, vendors and staff to identify and record principal/secondary diagnoses and procedures, and DRG assignments. Manage HIM physician advisors to ensure flow of queries and chart reviews. Utilize tools to track productivity, quality and timeliness of coding programs; interpret findings and report to HIM Director and hospital administration. Hire and train coding staff to ensure timely, accurate and high-quality coding while optimizing revenue and maintaining compliance. Serve as Carle’s point of contact for coding questions. Attend meetings as needed. Maintain internal controls and management reports to monitor accounts receivable, productivity and quality; maintain AR days under 5. Review and follow up on PRO/Insurance review correspondence related to medical record documentation and coding. Review DRG changes/denials and prepare letters of correspondence/appeal when needed. Work with RAC coordinator on government audits and reviews; provide input for payer-specific coding audits and reviews. Maintain active involvement in regulatory compliance functions with up-to-date knowledge of coding, reimbursement and care management trends. Collaborate with the EMR team to ensure record compliance with state and federal laws. Prepare and manage budgets for all coding areas.
Qualifications
Certifications:
Certified Outpatient Coder (COC) or Certified Inpatient Coder (CIC) or Licensed Registered Professional Nurse (RN) or Certified Coding Specialist - Physician-Based (CCS-P) or Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) or Registered Health Information Administrator (RHIA) or Certified Professional Coder (CPC) Education:
Bachelor\u2019s Degree: Related Field Work Experience:
Hospital Inpatient (Acute Care) and Outpatient Coding - 5 years Coding Supervisory or Management - 3 years Experience leading a large remote workforce - 45 FTE or greater System experience within a multi-hospital healthcare system Specialized Knowledge And Skills Requirements:
Strong background in CPT, HCPCS and ICD coding Knowledge of relevant coding regulatory requirements Excellent written and verbal communication skills Working knowledge of healthcare payment systems Ability to work with physicians and staff at all levels Ability to educate and advise physicians and staff Working knowledge of Microsoft Office, Computer Assisted Software and Encoders Working knowledge of state and federal healthcare billing requirements Strong critical thinking, organizational and time-management skills
Education and Experience
Bachelor's Degree in a Related Field 5 years hospital inpatient and outpatient coding experience 3 years coding supervisory or management experience
Benefits and About Us
About Carle Health: Based in Urbana, IL, Carle Health is a healthcare system with nearly 16,600 team members across eight hospitals, physician groups and affiliated businesses. We offer opportunities in central Illinois with growth and career development. Carle Health is an Equal Opportunity Employer and participates in E-Verify.
Compensation
The compensation range for this position is $40.88 per hour - $70.31 per hour. Actual offer depends on experience, location, licenses, shifts worked, and compensation model. We offer a comprehensive benefits package. For details visit careers.carlehealth.org/benefits.
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The Health Information Management Coding Manager provides day-to-day oversight, direction and management for the hospital inpatient and hospital outpatient functions within the Carle Health system. The Coding Manager ensures the quality, accuracy and timeliness of all the coding completed within Health Information Management. The position is responsible for planning, analyzing and development of operations, procedures and processes with respect to coding. The role acts as a liaison and consultant for other departments with respect to coding and coding regulatory requirements. The coding manager is responsible for yearly cost center budgeting and advises the HIM Director in the area of coding, coding education, coding software, coding staffing and budgeting. The coding manager is responsible to ensure appropriate staffing for all areas coded by Health Information Management.
Responsibilities
Communicates effectively with internal and external customers. Identify and resolve issues regarding billing, reimbursement, coding, audits or case mix index. Conduct regular audits and ongoing monitoring of coding accuracy. Provide feedback and focused educational programs on audit results to affected physicians and organizational staff. Report coding quality and accuracy regularly according to HIM policy. Supervise and manage all inpatient and outpatient coding activities and staff for the Carle Health system. Directly assist and mentor clinical staff, administration, department managers and compliance staff regarding coding standards, guidelines and regulatory requirements. Ensure dissemination of regulatory or compliance guidelines and changes related to coding. Coordinate with Concurrent Clinical Documentation Specialists, inpatient/outpatient/physician coders, physician advisors, vendors and staff to identify and record principal/secondary diagnoses and procedures, and DRG assignments. Manage HIM physician advisors to ensure flow of queries and chart reviews. Utilize tools to track productivity, quality and timeliness of coding programs; interpret findings and report to HIM Director and hospital administration. Hire and train coding staff to ensure timely, accurate and high-quality coding while optimizing revenue and maintaining compliance. Serve as Carle’s point of contact for coding questions. Attend meetings as needed. Maintain internal controls and management reports to monitor accounts receivable, productivity and quality; maintain AR days under 5. Review and follow up on PRO/Insurance review correspondence related to medical record documentation and coding. Review DRG changes/denials and prepare letters of correspondence/appeal when needed. Work with RAC coordinator on government audits and reviews; provide input for payer-specific coding audits and reviews. Maintain active involvement in regulatory compliance functions with up-to-date knowledge of coding, reimbursement and care management trends. Collaborate with the EMR team to ensure record compliance with state and federal laws. Prepare and manage budgets for all coding areas.
Qualifications
Certifications:
Certified Outpatient Coder (COC) or Certified Inpatient Coder (CIC) or Licensed Registered Professional Nurse (RN) or Certified Coding Specialist - Physician-Based (CCS-P) or Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) or Registered Health Information Administrator (RHIA) or Certified Professional Coder (CPC) Education:
Bachelor\u2019s Degree: Related Field Work Experience:
Hospital Inpatient (Acute Care) and Outpatient Coding - 5 years Coding Supervisory or Management - 3 years Experience leading a large remote workforce - 45 FTE or greater System experience within a multi-hospital healthcare system Specialized Knowledge And Skills Requirements:
Strong background in CPT, HCPCS and ICD coding Knowledge of relevant coding regulatory requirements Excellent written and verbal communication skills Working knowledge of healthcare payment systems Ability to work with physicians and staff at all levels Ability to educate and advise physicians and staff Working knowledge of Microsoft Office, Computer Assisted Software and Encoders Working knowledge of state and federal healthcare billing requirements Strong critical thinking, organizational and time-management skills
Education and Experience
Bachelor's Degree in a Related Field 5 years hospital inpatient and outpatient coding experience 3 years coding supervisory or management experience
Benefits and About Us
About Carle Health: Based in Urbana, IL, Carle Health is a healthcare system with nearly 16,600 team members across eight hospitals, physician groups and affiliated businesses. We offer opportunities in central Illinois with growth and career development. Carle Health is an Equal Opportunity Employer and participates in E-Verify.
Compensation
The compensation range for this position is $40.88 per hour - $70.31 per hour. Actual offer depends on experience, location, licenses, shifts worked, and compensation model. We offer a comprehensive benefits package. For details visit careers.carlehealth.org/benefits.
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