Saint Anne's Hospital
Job Details: Bachelor's degree is required. Certification is required. 7 - 10 years experience required. Summary: The Senior Manager, Coding Auditing & Training manages the team responsible for leading CPT assignment training for newly onboarded physicians and mid-level providers across all Steward Medical Group markets. The activities performed by this team include: auditing new providers as described per SMG policy, educating\/re-educating coding staff and providers as necessary, reviewing and validating various charges generated by providers, and participating in facility committees and ad hoc meetings as requested. The Senior Manager is the leader of the team and expected to perform in accordance with all policies and procedures, follow standards for ethical business conduct, and serve as a positive role model for the team. This position will report to directly to the Director of Revenue Integrity, who oversees all coding and compliance functions. Job Duties: \u2022\u00a0Lead daily operations of the Training and Auditing function and staff, including monitoring the quality and quantity of workflow to ensure the completion of work assignments. \u2022\u00a0Provide oversight for coding, documentation, and billing audits, including summarizing audit findings and proposing recommendations. Oversee implementation of audit recommendations as appropriate. Perform follow-up audits and reviews to monitor and validate ongoing compliance with applicable rules and guidelines. \u2022\u00a0Educate practices\/providers on basic coding, documentation, and billing issues related to appropriately entering charges and documenting the services delivered in compliance with applicable rules and regulations. \u2022\u00a0Coordinate and direct internal staff and external coding resources in order to meet specific objectives and timelines for coding activities. \u2022\u00a0Educate key stakeholders on significant matters related to coverage decisions, coding issues, and new or revised regulations. \u2022\u00a0Maintain excellent intradepartmental communication and build\/maintain relationships with Practice Management and other departments and employees throughout Steward. \u2022\u00a0Based on experience and industry knowledge, make recommendations to streamline processes related to accurate and appropriate revenue capture for services performed, ensuring compliance with all appropriate regulations and guidelines. \u2022\u00a0Identify and implement improvement measures that will enhance department operations and customer service. \u2022\u00a0Complete required continuous training and education, including department specific requirements. \u2022\u00a0Maintain certifications and stay current on industry trends. \u2022\u00a0Design and implement work flow processes to support continuous improvement. \u2022\u00a0Provide cost effective management of resources for the Training and Auditing team. \u2022\u00a0Monitor and report all required performance measures to include the development of department goals and assist in the assessment of goal attainment. \u2022\u00a0Conduct and recommend trainings to improve team performance. \u2022\u00a0Resolve any employee personnel issues by following SMG's HR policies, including escalating issues as required. Qualifications Required: \u2022\u00a0Bachelor's degree \u2022\u00a010 years coding experience, 5 years of management experience \u2022\u00a0Advanced experience utilizing Microsoft Excel, including Pivot tables \u2022\u00a0Beginner\/Intermediate experience with Microsoft Access preferred \u2022\u00a0Thorough knowledge of health care operations, physician practice reimbursement (including RVUs), charging practices, governmental coding requirements (including extensive knowledge of CPT\/HCPCS\/ICD and modifiers), and healthcare financial systems \u2022\u00a0Experience in researching, interpreting, and applying Medicare, Medicaid, MASSHEALTH, and other third-party payer regulations is essential. \u2022\u00a0Excellent problem-solving ability, as well as analytical, communication, leadership, initiative, and management skills are a necessity \u2022\u00a0Current certification as a CPC or CCS-P is required \u2022\u00a0Certification in Health Care Compliance (CHC) highly desired
Saint Anne's Hospital
Website : https://www.saintanneshospital.org/home
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