Manager Network Coding

Description

Summary:

Manages daily operations for the Nuvance Health Professional Coding Audit and Education Department. Ensures timely internal professional coder and medical group physician audits, as well as coder and physician education and quality of the coded data to meet the organizational goals and standards. Coordinates coding related aspects of Nuvance Health Compliance Plans to meet Medicare guidelines and OIG requirements. Ensures proper education of coding staff and medical group physicians to get optimal results for revenue cycle. Ensures that Nuvance meets or exceeds the industry benchmarks for Coding and Documentation quality.

Responsibilities:

1. Oversees department workflows to ensure timely audit and education of professional fee coders and medical group clinicians, provide direction to staff regarding work assignments in various record categories to balance productivity with coders� skill sets and individual competences. Develops, maintains and enforces department policies and procedures. 

2. Oversees/performs on-going audits for E/M, diagnosis and procedure assignments, and quality and completeness of the record. Maintain record of the audit with the analysis of findings and feedback to the coders and medical practice clinicians. Oversees and coordinates annual external audits. 

3. Assures that all coding is based on physician documentation. Works with Practice Administrators, Physician liaisons and clinical staff to obtain complete documentation. Assists coding director to identify areas of documentation needing improvement. 

4. Maintains a working knowledge of ICD-10-CM, Evaluation and Management and CPT guidelines and changes, government regulations, Cerner/Soarian Financial, 3M software, as well as trends in the prospective payment system. Moved develops and maintains dept policies and procedures to #1 

5. Designates and executes an education program. Strengthens coders� knowledge of anatomy and physiology, ICD 10 coding guidelines, coding principals and methodology by providing continuous education through webinars, round tables, publications and workshops. 

6. Attends practice and service line meetings to stay current with information that may impact coders. Provides education needed for clinical documentation and compliance. Removed conducts monthly meetings 

7. Assists Director to develop and maintain the budget to reflect department needs. Achieves cost containment and optimal department and financial performance goals. Removed assists director with process improvement opportunities 

8. Troubleshoots research, coding and charging systems by closely working with ITG, system administrators and vendors to ensure timely resolution. Follows up and tests any system upgrades including all quarterly and yearly updates that impact coding and abstracting as needed 

9. Works with business office to inform education based on denials and claim edits. 

10. Fulfills all compliance responsibilities related to the position. 

11. Performs other duties as assigned

12. Maintains and Models Nuvance Health Values

13. Demonstrates regular, reliable and predictable attendance

Other Information:

Working Conditions:

Manual: significant manual skills/motor coord & finger dexterity

Occupational: Little or no potential for occupational risk

Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force

Physical Environment: Generally pleasant working conditions

Company: Western CT Health Network Inc

Org Unit: 1853

Department: CODERS - PROFESSIONAL & FACILITY CHARGING and CODING

Exempt: Yes

Salary Range: $40.43 - $75.10 Hourly