Supervisor Coding - Revenue Integrity (Museum District)

Job description

At Houston Methodist, the Supervisor Coding position is responsible for the supervision of correct coding conventions to inpatients, hospital outpatients, and ambulatory visits. The Supervisor is responsible for supervising staff process of abstracting diagnoses and procedures from hospital and physician office records and performing quality assurance and oversight to coding staff. The Supervisor has responsibility for overseeing the day-to-day operations of the coders by monitoring productivity, workflows, quality and timeliness of coding activities as well as necessary coverage and back up at month and year end. The Supervisor supervises the coding department in relation to the following: staffing, distribution of work assignments, modern technology information, reviewing and analyzing reimbursement trends, and assisting in providing education for physicians and revenue cycle staff. Additional responsibilities include supervising, tracking appropriate metrics and facilitating policies and procedures to maximize reimbursement while maintaining patient and physician satisfaction and adherence to compliance policies. The supervisor position responsibilities include overseeing the daily work activities of the work unit/department staff, ensuring quality, productivity, functional excellence and efficiency. This position trains and supervises staff while maintaining adequate staffing levels and budget compliance. The supervisor position contributes to staffing decisions such as hiring, coaching and counseling employees on work-related performance. This position assists in the development and implementation of policies and procedures to ensure a safe and effective work environment. Other duties for the supervisor position include participating in performance improvement activities, as well as providing support for department management to achieve operational goals. This position may also perform staff duties and responsibilities as needed. FLSA STATUS Exempt QUALIFICATIONS EDUCATION Associate’s degree; will consider an additional two years of certified coding experience in addition to the minimum experience requirements in lieu of degree EXPERIENCE Six years of experience in applicable coding operations; may consider HM employee with one year less experience who demonstrates progressive leadership abilities LICENSES AND CERTIFICATIONS Required Must have one of the following: • RHIT - Certified Health Information Technician (AHIMA) • RHIA - Registered Health Information Administrator (AHIMA) • CCS - Certified Coding Specialist (AHIMA) • CPC – Certified Professional Coder (AAPC) KNOWLEDGE AND ABILITIES Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through ongoing skills, competency assessments, and performance evaluations Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security Ability to effectively communicate through a variety of channels with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles; engages the recipient(s) and helps them understand and retain the message Demonstrates the ability to interact with others in a way that gives them confidence in one’s intentions and those of the organization Demonstrates leadership qualities and critical thinking through self-direction initiative, effective interpersonal skills, and oral/written communication skills Ability to identify and understand issues, problems and opportunities; and recommend solutions Ability to work effectively in a fast paced environment Demonstrates flexibility and adaptability in the workplace Thorough understanding of CPT/ICD-9/ICD-10-DX/ICD-10-PCS coding, MS-DRG, APR-DRG and APC assignment systems Thorough understanding of managed care contracting, third party and governmental payers, billing and compliance regulations, and computerized billing and collection management systems Expert knowledge of official coding guidelines, medical terminology, anatomy and physiology, disease processes, and pharmacology Proficient with electronic encoder application and electronic health record systems Extensive computer knowledge and proficient in Microsoft Office product ESSENTIAL FUNCTIONS PEOPLE ESSENTIAL FUNCTIONS Participates in management responsibilities of selection, scheduling, supervision, retention, and evaluation of employees in the department. Provides development and mentoring of staff. Ensures that all department staff are properly trained and comply with all policies and procedures. Assists with meeting or exceeding threshold goal for department turnover. Consults with department leadership on coaching/corrective counseling and staff performance to achieve desired outcomes. Conducts new hire feedback sessions and provides recognition/commendations, as appropriate. Creates and maintains an environment of collaboration by role modeling teamwork within the department. Effectively interacts within and between departments ensuring seamless flow of information/communication. Role models clear and professional communication to facilitate problem resolution to achieve mutual understanding. Teaches others to think critically by verbally expressing rationale for decisions and follows up consistently. Meets or exceeds threshold goal for department and/or system metrics on employee engagement indicators. Establishes and maintains strong, effective working relationships with physicians, peers, and healthcare professionals; effectively communicates with internal and external customers including IT and Business Practices. Monitors workflows to optimize internal coding education and procedures and communicates regularly with physicians and physician office staff on clarification to accurately code diagnosis and procedures SERVICE ESSENTIAL FUNCTIONS Oversees daily department operations, schedule and activities. Sets priorities and functional standards, giving direction to staff as necessary to ensure the best possible delivery of service and high customer/patient satisfaction. Organizes the workflow, proactively problem solves, anticipates needs, and manages multiple ongoing priorities. Provides reports to management of needs, issues to be addressed, and all important information necessary to ensure department success. Serves and actively participates on various committees as directed. Ensures inpatient, hospital outpatient, and ambulatory visits are coded timely and monitors delays. Enforces coding standards and guidelines consistently across all account and payor types. Codes inpatients, hospital outpatients, ambulatory visits, surgery charges and office procedures as needed to support coders and departments. Responds to or clarifies internal requests for coding review by coders or department representatives. QUALITY/SAFETY ESSENTIAL FUNCTIONS Ensures a safe and effective working environment; assists in monitoring and/or revising the department safety plan and/or any specific accreditation/regulatory agency required safety guidelines. Uses and optimizes information systems to enhance operations; participates in performance improvement and data management/analysis functions as directed. Employs a proactive approach in the optimization of positive outcomes by monitoring and improving the department workflow, supporting peer-to-peer accountability, and identifying solutions via collaboration. Role models situational awareness, using teachable moments to improve safety. Participates in investigations as a result of the root cause analysis process as assigned by manager. Monitors self and ensures employee compliance with policies, procedures, and System HR Standards of Practice and performs associated actions upon non-compliance (i.e., focal point review requirements, disaster plan, in services, influenza immunization, wage and hour, standard hours, timely termination submission, timely timecard approval, etc.). Applies and monitors performance metrics for coding teams and ensures standards are met. Implements action plan to reduce clinical denials and coordinates department training. FINANCE ESSENTIAL FUNCTIONS Assists in the management of essential and non-essential department expenditures to achieve financial target through optimization of productivity, supply/resource efficiency, minimizing incidental overtime and overtime percentage, and other areas according to department specifications. Manages staffing needs including scheduling, time off requests and time keeping. Monitors staff daily responsibilities including the oversight of coding staff work queue activity and duties to ensure timely and accurate processing for resolution and within established performance standards and accounts receivable (AR) metrics. Oversees the investigation and appeal of unpaid and partially paid claims by third-party payors related to coding or clinical denials. GROWTH/INNOVATION ESSENTIAL FUNCTIONS Implements change, demonstrating the ability to motivate employees and follow through to ensure change in behavior has actually occurred. Supports Houston Methodist and department goals and vision. Identifies industry trends and implements innovative solutions for practice or workflow changes to improve department operations. Develops skills of team members and continually assists with improving competencies, performance and outcomes. Fosters a positive and constructive teaching environment by engaging staff/team members in learning opportunities that are valuable and in alignment with business objectives. Conducts conversations with staff on their development and My Development Plan (MDP). Seeks opportunities to identify self-development needs and takes appropriate action. Ensures own career discussions occur with appropriate management. Completes and updates MDP on an ongoing basis. Remains current on all coding procedures and assignments and implements training and coaching plans for all levels of staff to provide continuous coding education as it relates to International Classification of Diseases 10th Revision (ICD-10), Current Procedural Terminology (CPT), and The Healthcare Common Procedure Coding System (HCPCS) coding and ensures consistency between departments and coders. SUPPLEMENTAL REQUIREMENTS WORK ATTIRE Uniform: No Scrubs: No Business professional: Yes Other (department approved): No ON-CALL* *Note that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Events, etc) regardless of selection below. On Call* No TRAVEL** **Travel specifications may vary by department** May require travel within the Houston Metropolitan area Yes May require travel outside Houston Metropolitan area No Work Shift : 1 - Day (United States of America) Job Category : Non-clinical Houston Methodist Specialty Physician Group is an integral part of Houston Methodist’s overall strategy to become one of the nation’s leading academic medical centers. Established as a nonprofit corporation certified by the Texas State Board of Medical Examiners, the Specialty Physician Group enables physicians to maintain autonomy with respect to clinical practice while growing their practice within an academic environment. Houston Methodist is an Equal Opportunity Employer.