Job Description

Position SummaryWorking under the general direction of the Director of Compliance, oversees and manages 6+ employees responsible for coding and documentation review, auditing, and charge release within a hybrid remote & onsite work environment. ResponsibilitiesWorking under the general direction of the Director of Compliance, oversees and manages 6+ employees responsible for coding and documentation review, auditing, and charge release within a hybrid remote & onsite work environment.Responsible for staff assignment or reassignment based on operational needs, special projects, or changes in charge volume and throughput.Ensures staff adhere to productivity metrics. Carefully monitors staff productivity and can assess reasonable adjustments to productivity based on staff time and effort to review CPTs and diagnosis codes, and clinical documentation.Conduct random audits of CPT and Diagnosis coding in relation to the provider clinical documentation to ensure staff consistently code according to the clinical documentation, CMS, or NCC/ requirements. Educates staff as needed to improve quality and consistencyRecognize pre-billing charge edit trends and causative factors and can identify the appropriate action to take to resolve. Identifies common warning and error trends, and identifies specific causative factors (system, provider, or operations related) and can take appropriate action to resolve.Collaborate with OBGYN coding and documentation compliance to identify provider education needs to ensure compliance or identify revenue opportunities. Develops and evaluates education material and plans meetings/presentations with the provider community. Follows up with provider to ensure compliance, as needed.Represents the department in informational meetings and workgroups as an active participant.Full understanding of incident to and other billing requirements.