Direct Jobs
Outpatient Coding QA & Reimbursement Supervisor
Direct Jobs, Granite Heights, Wisconsin, United States
Job Summary
Harris Health System is the public healthcare safety-net provider established in 1966 to serve the residents of Harris County, Texas. This role leads and supports outpatient coding and clinical documentation improvement by supervising audit and reimbursement teams, driving accuracy, and ensuring compliance with OPPS and CMS guidelines. The position develops performance scorecards, manages workflows for audits and denials, and delivers targeted education to enhance coding quality and reduce compliance risk. Acting as a key resource for coding queries and quality reporting, this role fosters collaboration across departments and promotes continuous professional development through CEU-eligible training initiatives. Minimum Qualifications
Degrees:
Bachelors: Health Information Management and/or equivalate (Preferred); Associates: Health Information Management Licenses & Certifications:
Registered Health Information Administrator (RHIA) (Preferred); Registered Health Information Technician (RHIT); Certified Coding Specialist (CCS); Certified Outpatient Coder (COC) Work Experience:
Five (5) Years of Experience in Outpatient Coding and Training. Management Experience
Three (3) Years of Experience in Leadership, Supervisory, or Auditing. Communication Skills
Above Average Verbal Communication (Heavy Public Contact) Exceptional Verbal (Public Speaking) Writing/Correspondence Writing/Reports Job Attributes
Knowledge/Skills/Abilities:
Analytical Abilities; Design; Medical Terms; Research Knowledge and Abilities; Statistical Knowledge and Abilities Work Schedule
Eligible for Telecommute; Flexible. Other Special Requirements
Other Requirements
Microsoft Suite: MS Word, MS PowerPoint, MS Excel, MS Outlook, MS Access, MS Project Detailed knowledge of coding conventions and rules established by the American Medical Association (AMA), the Center for Medicare and Medicaid Services (CMS), the ICD-10-CM Official Coding Guidelines, and AHIMA for assignment of diagnostic and procedural codes. Detailed knowledge of medical terminology, abbreviations, anatomy and physiology, major disease processes, and pharmacology. Detailed knowledge of classification systems of ICD-10 CM and PCS nomenclature, coding rules, guidelines, and proper sequencing. Knowledge of JCAHO, Privacy Act of 1974, and HIPAA standards affecting medical records and their impact on reimbursement. Knowledge of ethical coding principles and revenue cycle activities. Skill in interpreting and applying ethical coding standards, understanding federal and state laws and regulations, and following professional practice standards for health care organization coding compliance program activities. Detailed knowledge of Clinical Documentation Improvement practices from Association of Clinical Documentation Integrity Specialists (ACDIS). Proficient in compliant query practices. Detailed comprehension of AHRQ quality indicators and manual guidelines along with qualifying inclusionary and exclusionary conditions. Equipment Operated
Regular office equipment and 3M 360 encoder interfaced with EPIC electronic medical record billing system.
#J-18808-Ljbffr
Harris Health System is the public healthcare safety-net provider established in 1966 to serve the residents of Harris County, Texas. This role leads and supports outpatient coding and clinical documentation improvement by supervising audit and reimbursement teams, driving accuracy, and ensuring compliance with OPPS and CMS guidelines. The position develops performance scorecards, manages workflows for audits and denials, and delivers targeted education to enhance coding quality and reduce compliance risk. Acting as a key resource for coding queries and quality reporting, this role fosters collaboration across departments and promotes continuous professional development through CEU-eligible training initiatives. Minimum Qualifications
Degrees:
Bachelors: Health Information Management and/or equivalate (Preferred); Associates: Health Information Management Licenses & Certifications:
Registered Health Information Administrator (RHIA) (Preferred); Registered Health Information Technician (RHIT); Certified Coding Specialist (CCS); Certified Outpatient Coder (COC) Work Experience:
Five (5) Years of Experience in Outpatient Coding and Training. Management Experience
Three (3) Years of Experience in Leadership, Supervisory, or Auditing. Communication Skills
Above Average Verbal Communication (Heavy Public Contact) Exceptional Verbal (Public Speaking) Writing/Correspondence Writing/Reports Job Attributes
Knowledge/Skills/Abilities:
Analytical Abilities; Design; Medical Terms; Research Knowledge and Abilities; Statistical Knowledge and Abilities Work Schedule
Eligible for Telecommute; Flexible. Other Special Requirements
Other Requirements
Microsoft Suite: MS Word, MS PowerPoint, MS Excel, MS Outlook, MS Access, MS Project Detailed knowledge of coding conventions and rules established by the American Medical Association (AMA), the Center for Medicare and Medicaid Services (CMS), the ICD-10-CM Official Coding Guidelines, and AHIMA for assignment of diagnostic and procedural codes. Detailed knowledge of medical terminology, abbreviations, anatomy and physiology, major disease processes, and pharmacology. Detailed knowledge of classification systems of ICD-10 CM and PCS nomenclature, coding rules, guidelines, and proper sequencing. Knowledge of JCAHO, Privacy Act of 1974, and HIPAA standards affecting medical records and their impact on reimbursement. Knowledge of ethical coding principles and revenue cycle activities. Skill in interpreting and applying ethical coding standards, understanding federal and state laws and regulations, and following professional practice standards for health care organization coding compliance program activities. Detailed knowledge of Clinical Documentation Improvement practices from Association of Clinical Documentation Integrity Specialists (ACDIS). Proficient in compliant query practices. Detailed comprehension of AHRQ quality indicators and manual guidelines along with qualifying inclusionary and exclusionary conditions. Equipment Operated
Regular office equipment and 3M 360 encoder interfaced with EPIC electronic medical record billing system.
#J-18808-Ljbffr