Manager- Coding / Charge Capture, Vancouver, WA
Manager- Coding / Charge Capture
Evergreen Vancouver, WA
Responsible for managing all facets of charge capture and coding, including charge review and coding related claim edits. Position educates providers regarding coding compliance and documentation requirements to optimize reimbursement in accordance with federal guidelines and payor specific policies and procedures.
I. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
- Ensures the timely and accurate capture of charges, and submission of clean claims.
- Ensures that physician documentation supports medical necessity and substantiates services provided.
- Implements strategies to reduce uncollected reimbursement related to charge capture, documentation, and coding.
- Ensures that excellent patient service is a focal point and all patient account questions are answered promptly, completely, accurately, and courteously.
- Maintains an in-depth knowledge of insurance carrier policies and contracts to ensure optimal reimbursement and compliance with contract terms.
- Works collaboratively with Medical Affairs to educate providers on the appropriateness of coding and billing compliance.
- Maintains an in-depth understanding of federal and state billing regulations and ensures billing compliance.
- Assures correct CPT and ICD10 coding.
- Monitors coding denials to identify potential problem areas and takes prompt, effective action to ensure timely, appropriate reimbursement.
- Monitors workflows and system-enhancement opportunities to optimize efficiency and effectiveness.
- Recommends creates charge review edits and charge router rules to more efficiently and effectively capture charges for optimal, compliant reimbursement.
- Responsible for the hiring, job performance, review and discipline.
- Builds relationships with providers to ensure trust in coding expertise and foster open lines of communication.
- Works with Clinic Managers to assure that decentralized charge entry and coding have effective policies and procedures which are consistently followed clinic-wide.
- Work collaboratively with all TVC departments to ensure optimal charge capture and coding efficiency and effective use of resources.
- Other related duties as necessary.
This job description reflects management's assignment of essential functions; it does not prescribe or restrict the tasks that may be assigned.
Establish & maintain solid work relationships, through communication, cooperation, and positive interaction with all employees, staff and physicians.
- Approachability – build rapport by making the effort to be cooperative and adaptive, put others at ease, and support co-workers.
- Listening – practice active listening; display patience when listening to the views of others, and discuss differing opinions with an open mind.
- Dealing with ambiguity and change – avoid getting upset when things are ambiguous. Remain flexible and view new tasks or situations as opportunities.
- Problem Solving – work with others to prevent problems & find a solution when issues arise.
Customer & Patient Service
Exhibit professional behavior while being caring and compassionate.
- Customer Focus – dedicated to meeting the expectations of internal and external customers. Demonstrate sensitivity, empathy, concern and respect for others. Act with the patient in mind, gain trust and respect by building and maintaining effective relationships.
- Problem Solving - seek to solve the patient’s problem or provide adequate resolution. Compromise when appropriate.
- Maintain confidentiality – in accordance with the Clinic and HIPAA regulations.
Effective Use of Resources
Maximize the Clinic’s resources while minimizing waste and controlling expenses. This includes the effective use of work time and supplies, working safely, following established work practices, and seeking ways to improve operations.
- Productivity - increase throughput and minimize waste of time and materials.
- Improvement – recommend procedures that reduce costs and streamline operations while improving quality.
- Maintain neat, clean and professional work area.
Self motivated and contribute to new ideas.
- Improvements – initiate improvements and apply new methods of working to help the Clinic achieve goals.
- Learning on the go – develop an action plan when facing new problems, and be open to change. Experiment to find new solutions to problems. Seek to find the underlying root cause of problems to prevent future occurrences.
- Seek additional work to help co-workers, acquire additional skills, and promote efficiency.
Responsible for coding and charge capture staff.
EDUCATION AND SKILLS
- Bachelor’s degree in Health Care or Business-related field required.
- Minimum of four years management experience in health information management or coding, or accounts receivable management required.
- Must have one of the following coding credentials: AHIMA (CCA, CCS, CCS-P, or RHIT); AAPC (CPC, CPC-A, CPC-H, CPC-H-A, or one of the relevant AAPC specialty-specific coding credentials.
- Ability to interpret insurance medical policies and procedures.
- Professional use of financial reporting and use of spreadsheets.
- Must be a proactive problem solver, demonstrate leadership skills, foster teamwork and trust.
- Highly skilled in prioritizing, organizing, planning, and communication.
- Proficiency with Microsoft Office Suite with excellent Excel and presentation skills.
- Experience with physician practice management (billing) software required, Epic experience preferred.
- Must be able to work in a fast-paced environment.
- Analytical skills, critical thinking, and creativity.
- Excellent written and verbal communication skills; ability to interact professionally with all levels within the organization and with external vendors and patients.
- Must have reliable and predictable attendance.
We offer a competitive wage and a comprehensive benefits package which includes insurance programs covering medical, dental, vision, life, long-term disability, paid time off, education reimbursement, and a 401(k) plan. We are proud to be an equal opportunity employer.