Coding Quality Supervisor - Central Billing Office *Onsite - Las Vegas, NV*
Las Vegas, NV Las Vegas, NV Full-time Full-time $60,530 - $90,795 a year $60,530 - $90,795 a year Position
Summary:
Reporting to the Coding Quality Manager, the coding quality supervisor will coordinate all aspects of coding review, claim submission, charge reconciliation and follow-up on claims denied for coding-related reasons for various specialties and providers.
Provide coding, financial and/or operational reports, and provide feedback to providers to improve documentation to maximize revenue and reduce denials.
Review and advise physicians and staff with regard to local and national coding and reimbursement policies.
Work with patients and guarantors to clarify financial responsibilities as a part of the revenue cycle team.
Job
Responsibilities:
Perform and meet or exceed the accountabilities of the Coding Coordinator I, II, and III roles and serve as a role model and resource to entry-level team members.
As an individual contributor, meet CBO quality and productivity targets.
Manage a team responsible for performing revenue cycle functions with a focus on coding and receivables denied for coding.
Monitor reports and work queues, ensuring charge submission and accounts receivable follow-up is occurring on a timely basis.
Demonstrate a significant level of expertise in subject matter to assist and mentor entry-level billing staff, support the Coding Quality Manager in managing day-to-day team activities against scope and timeline, and ensure timely reporting of activities.
Provide feedback and contribute to employee performance reviews.
Directly supervise employees, establish priorities, assign work, and follow up to ensure assignments are complete.
Select, orient, and evaluate staff.
Provide initial and ongoing training and guidance.
Resolve employee issues and address procedure and performance related issues.
Review outstanding accounts receivable to maintain minimal level of open accounts.
Review practice Action Plans and/or reports on a timely basis.
Analyze issues to identify trends in denial rates to focus improvement initiatives on, and charges that requires action.
Take initiative to teach and share new information and provide constructive feedback; Communicate delays and workqueue issues to management daily.
Compile statistical data as requested and reports data monthly to appropriate parties.
Objectively review and Audit clinical documentation, CPT-4, HCPCS, modifiers and ICD-10 coding to ensure accurate reimbursement and compliance with CMS and third party payer laws and regulations.
Determine and establish the explanation to complex claims, issues, and questions not covered by specific instructions or common practice.
Compare coding to notes/documentation and communicate with practice and or providers to clarify errors.
Communicate with, and train, coding and A/R vendors as it relates to various coding, reimbursements, billing processes and collections.
Adhere to general practice and FGP guidelines on compliance issues and patient confidentiality.
Identify issues and suggest improvements and available tools to physicians and admin support staff to address issues.
Escalate issues as needed to practice and FGP Leadership.
Serve as resource to physicians, staff, and management regarding local and national coding and reimbursement policies.
Educate physicians, staff, and management on new policies and changes to existing policies.
Review and respond to practice, physician, and patient inquiries following CBO guidelines.
Work with practice operations to implement changes to improve revenue where necessary.
Collaborate with Revenue Integrity to understand CPT and ICD-10 manuals, payer policy and procedure manuals, updates, and CMS publications to ensure practices are compliant with current policies and procedures.
Research and update new and/or revised coding and compliance standards utilizing multiple government resources including:
CMS, AMA, OIG, etc.
Assist with special projects as needed.
Minimum
Qualifications:
Bachelors Degree with a minimum of 3-5 years of relevant work experience or equivalent combination or training and relevant work experience.
Current medical coding certification (CPC) required for coding related roles.
Ability to handle multiple tasks at once; good communication, interpersonal, and computer skills.
Arrive on time for work and meetings.
Ability to develop and maintain effective working relationships with staff and patients.
Maintain current insurance regulatory policies and requirements relevant to the specialty.
Knowledge of medical terminology required.
Familiar with standard office equipment.
Certified Coding Specialist Certification (CCS) or Certified Coding Specialist- Physician-based (CCS-P) or Certified Professional Coder (CPC), Certified Outpatient Coding (COC).
Estimated Salary: $20 to $28 per hour based on qualifications.
Summary:
Reporting to the Coding Quality Manager, the coding quality supervisor will coordinate all aspects of coding review, claim submission, charge reconciliation and follow-up on claims denied for coding-related reasons for various specialties and providers.
Provide coding, financial and/or operational reports, and provide feedback to providers to improve documentation to maximize revenue and reduce denials.
Review and advise physicians and staff with regard to local and national coding and reimbursement policies.
Work with patients and guarantors to clarify financial responsibilities as a part of the revenue cycle team.
Job
Responsibilities:
Perform and meet or exceed the accountabilities of the Coding Coordinator I, II, and III roles and serve as a role model and resource to entry-level team members.
As an individual contributor, meet CBO quality and productivity targets.
Manage a team responsible for performing revenue cycle functions with a focus on coding and receivables denied for coding.
Monitor reports and work queues, ensuring charge submission and accounts receivable follow-up is occurring on a timely basis.
Demonstrate a significant level of expertise in subject matter to assist and mentor entry-level billing staff, support the Coding Quality Manager in managing day-to-day team activities against scope and timeline, and ensure timely reporting of activities.
Provide feedback and contribute to employee performance reviews.
Directly supervise employees, establish priorities, assign work, and follow up to ensure assignments are complete.
Select, orient, and evaluate staff.
Provide initial and ongoing training and guidance.
Resolve employee issues and address procedure and performance related issues.
Review outstanding accounts receivable to maintain minimal level of open accounts.
Review practice Action Plans and/or reports on a timely basis.
Analyze issues to identify trends in denial rates to focus improvement initiatives on, and charges that requires action.
Take initiative to teach and share new information and provide constructive feedback; Communicate delays and workqueue issues to management daily.
Compile statistical data as requested and reports data monthly to appropriate parties.
Objectively review and Audit clinical documentation, CPT-4, HCPCS, modifiers and ICD-10 coding to ensure accurate reimbursement and compliance with CMS and third party payer laws and regulations.
Determine and establish the explanation to complex claims, issues, and questions not covered by specific instructions or common practice.
Compare coding to notes/documentation and communicate with practice and or providers to clarify errors.
Communicate with, and train, coding and A/R vendors as it relates to various coding, reimbursements, billing processes and collections.
Adhere to general practice and FGP guidelines on compliance issues and patient confidentiality.
Identify issues and suggest improvements and available tools to physicians and admin support staff to address issues.
Escalate issues as needed to practice and FGP Leadership.
Serve as resource to physicians, staff, and management regarding local and national coding and reimbursement policies.
Educate physicians, staff, and management on new policies and changes to existing policies.
Review and respond to practice, physician, and patient inquiries following CBO guidelines.
Work with practice operations to implement changes to improve revenue where necessary.
Collaborate with Revenue Integrity to understand CPT and ICD-10 manuals, payer policy and procedure manuals, updates, and CMS publications to ensure practices are compliant with current policies and procedures.
Research and update new and/or revised coding and compliance standards utilizing multiple government resources including:
CMS, AMA, OIG, etc.
Assist with special projects as needed.
Minimum
Qualifications:
Bachelors Degree with a minimum of 3-5 years of relevant work experience or equivalent combination or training and relevant work experience.
Current medical coding certification (CPC) required for coding related roles.
Ability to handle multiple tasks at once; good communication, interpersonal, and computer skills.
Arrive on time for work and meetings.
Ability to develop and maintain effective working relationships with staff and patients.
Maintain current insurance regulatory policies and requirements relevant to the specialty.
Knowledge of medical terminology required.
Familiar with standard office equipment.
Certified Coding Specialist Certification (CCS) or Certified Coding Specialist- Physician-based (CCS-P) or Certified Professional Coder (CPC), Certified Outpatient Coding (COC).
Estimated Salary: $20 to $28 per hour based on qualifications.
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