Western Wisconsin Health

Introduction:

Western Wisconsin Health is seeking a full-time Coding Supervisor.

Under the direction of the HIM Director, the coding supervisor plans, organizes, directs, and controls day-to-day operations of the coding department. They will provide developmental feedback, training & direction to coding. The coding supervisor will also assist providers in removing the barriers between clinical and coding languages to allow for more specific and complete documentation while following coding ethics and policy & procedures. They will provide leadership for process improvement and redesign to improve customer satisfaction, reduce costs, and/or meet departmental and institutional goals and objectives. This position will also foster an environment of teamwork and service excellence within the department and promote morale by effectively communicating goals, standards and needs of the department and organization. All of this is done to support the organization’s mission while living our values.

Job Description:

ESSENTIAL DUTIES AND RESPONSIBILITIES

Daily Operations

  • Review workflow and processes and balance workload in coding department to meet targets
  • Ensure timely, accurate, and complete clinical data for billing, reimbursement, utilization, and patient information systems
  • Ensure proper staffing and distribution of assignments
  • Act as a resource for the coding staff as well as serves as a liaison in the organization to address coding related issues and questions and assist HIM director and Patient Financial
  • Services with questions or denied claims
  • Use coding systems to accurately code diagnosis and procedures for all inpatient, outpatient surgery, observation, ER, and other outpatient encounters
  • Work closely with finance to establish AR goals and maintain AR days at an acceptable level and track DNFB (discharged not final billed)
  • Monitor coding systems to ensure optimal performance, recommend upgrades or changes to current system, and participate in selection of new systems
  • Ensure records are coded within established guidelines and facility requirements while still maintaining quality
  • Oversee coding educational needs by preparing and completing materials for internal and external audits, regulatory changes, and other changes in medical advancements
  • Utilize coding/abstracting systems and ensure that appropriate computer systems are updated with the annual code changes and any other associated changes or updates
  • Monitor operating budget for the coding section
  • Provide leadership for process improvement and redesign to improve customer satisfaction, reduce costs, and/or meet departmental and institutional goals and objectives
  • Create consistency and efficiency in claims processing and data collection to optimize MS-DRG and APC reimbursement
  • Assist in denial management

Compliance

  • Develop, implement and monitor policies and procedures, guidelines, and coding compliance plan for coding
  • Conduct internal chart reviews for all settings of selected patient records to address legibility, clarity, completeness, consistency, and precision of clinical documentation
  • Coordination and oversight of external chart reviews
  • Develop and manage peer/peer process
  • Assure codes are supported by provider documentation and initiates appropriate queries based upon other clinical documentation for accurate and reliable data collection and reimbursement in a manner that is compliant and efficient
  • Monitor changes and ensure compliance with the Office of Inspector General, Centers for
  • Medicare & Medicaid Services, and state and federal regulations

Documentation Improvement

  • Demonstrate understanding of clinical documentation requirements to ensure that the severity of illness, risk of mortality, and services provided are accurately reflected in the record. Serve as a resource on appropriate clinical documentation
  • Communicate documentation discrepancies and coding definitions to the physicians both written and verbally as needed to clarify clinical documentation in accordance to query standards and/or policies
  • Collaborate with and educate physicians, the multi-disciplinary team, patient care services, case management, coding specialists and other healthcare disciplines regarding coding, documentation guidelines, and clinical documentation issues
  • Conduct 1:1 educational sessions with physicians and other healthcare team members related to specific documentation requirements
  • Utilize computer systems effectively and maintains record of reviews completed, queries completed and outcome of physician response

Supervision

  • With assistance from HIM Director, hire personnel, conduct performance evaluations, counsel employees in performance improvement, conflict resolution, disciplinary action, and coordination of employee schedules for adequate coverage
  • Coach and enforce staff on coding expectations and meeting goals related to quality, productivity standards and accuracy expectation
  • Promote morale by effectively communicating goals, standards and needs of the department and organization
  • Train new coders and assists with cross training in new areas
  • Participate in the performance improvement activities and attend in-service programs and other activities to promote professional growth and enhance knowledge in care documentation requirements
  • Attend and actively participate in staff meetings, participates in committees as requested
  • Assist with oversight of HIM Students going through coding/HIM internships/practicums
  • Other duties as assigned

Required Qualifications:

Western Wisconsin Health expects employees to understand and to incorporate the values of our organization in their day-to-day practice. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Minimum Qualifications

  • Bachelors of Science (B.S.) or equivalent degree from a four year college in Health Information Administration or an Associate’s Degree from a two year technical college in Health Information Technology
  • 3-5 years coding experience and supervision experience
  • RHIA, RHIT, or CCS credentialed; CCS-P or CDIP helpful

** Proof of Certification is required and must be keep current though out employment

* Proficient in ICD-10-CM/PCS, HCPCS and CPT coding systems and must have formal ICD-10 training education

** Proof of classroom and/or online completion required

  • Experience and proficient with inpatient, hospital outpatient and clinic HIM functions required
  • Experience in coding compliance program development and program leadership required
  • Knowledgeable regarding MS-DRGs, APCs, and official coding guidelines
  • Knowledgeable in medical terminology, A&P, abnormal lab results, disease processes, and pharmacology drug names
  • Knowledge of electronic health record systems for applying codes and/or checking codes for accurate assignment based on provider documentation
  • Familiarity with document improvement initiatives
  • Ability to manage conflicting priorities and handle multiple tasks/projects concurrently
  • Maintain the integrity of highly confidential business and patient information

Preferred Qualifications:

  • Experience with the leadership of, and demonstrated ability to cooperate with, regulatory, compliance, payer, quality assurance / performance improvement and disease management audit functions
  • Understanding of legal aspects of health information management and ability to maintain competency in all areas of HIM
  • Working knowledge of RHC (Rural Health Clinic) and CAH (Critical Access Hospital) regulations.
  • Demonstrated ability to work effectively with physicians and handle multiple tasks and educational activities
  • Excellent observation and decision making abilities
  • Ability to assess, evaluate, and teach all members of the care team
  • Ability to work independently and be self-directed
  • Ability to analyze, interpret and assimilate information from various sources
  • Demonstrated knowledge in using clinical information systems and office automation

** Epic Electronic health record (EHR) knowledge preferred
** Microsoft Office Suite

  • Knowledge of encoding/abstracting/grouping/compliance software
  • Strong communication (verbal and written), possess effective interpersonal skills, can work across departmental boundaries, facilitates problem resolution, and maintain a professional demeanor in difficult situations.
  • Possess enthusiasm and motivation to stimulate diverse individuals and groups
  • A high level of clinical skills required to participate collaboratively with all members of the care team. Strong critical thinking skills and exceptional ability to integrate knowledge

Education Qualifications:

Bachelors of Science (B.S.) or equivalent degree from a four year college in Health Information Administration or an Associate’s Degree from a two year technical college in Health Information Technology

Compensation/Benefits:

Western Wisconsin Health offers employees a competitive benefits package that includes:

  • Insurance Plans
  • Health
  • Dental
  • Life
  • Accidental Death & Dismemberment
  • Vision
  • Supplemental options through AFLAC
  • 403(b) Retirement Savings Plan – All employees are eligible to participate in the savings plan. Through payroll deductions, you can elect to contribute on a pre-tax basis toward your retirement. We offer matching contributions for eligible employees.
  • Paid Time Off – Western Wisconsin Health employees receive generous paid time off for vacation, illness, and other personal matters.
  • Fitness Center Membership – Western Wisconsin Health wishes to encourage healthy lifestyle choices. In support of that objective, all current employees are eligible for a free membership to the Fitness Center.

Instructions for Resume Submission:

Please apply online. Contact Erin Benson at erin.benson@wwhealth.org with any questions.

Apply Online: https://www.wwhealth.org/job_openings/coding-supervisor/