MANDATORY COVID-19 GUIDELINE:
As of March 15th, 2022, all onsite JSH employees must have received the necessary doses to complete the COVID-19 vaccine series (i.e., one dose of a single-dose vaccine or all doses of a multiple vaccine series) or have been granted a qualifying exemption, or are identified as having a temporary delay as recommended by the CDC. New hires also will be required to comply with this requirement before working onsite at any JSH facility.
Under the direction of the Coding/CDI Manager of the Health Information Management Department and according to established JSH policies and procedures, the Coding Supervisor is responsible for assisting in the day-to-day operations of the Coding program at JSH and ensures that all hospital, state and federal reporting guidelines are followed. The Coding Supervisor acts as a liaison with business office, patient registration, medical, and ancillary staff to resolve problems and improve workflows and documentation processes. The Coding Supervisor communicates regularly with the HIM Coding/CDI Manager, Operations Manager, as well as the Director of HIM.
ESSENTIAL FUNCTIONS
Daily operational oversight of all coding volume (incoming, back-end charge hold, edits, denials) to ensure needs are met by adjusting staffing, re-purposing coder/client support, investigating file/workflow issues, answering coder questions, ensure turnaround time is maintained or appropriate escalations are followed.
Leads a team of coders in the identification, collection, assessment, and validation of encounter information consistent with all regulatory and official coding guidance.
Identifies, communicates, and ensures that coding staff meet productivity and quality standards to support the financial goals of the organization.
Ensures that coding practices meet regulatory guidelines and the compliance goals of the organization, State and Federal regulatory and other monitoring agencies as well as private carrier requirements, external audit and the Kentucky State reporting functions.
Provides guidance and motivation to staff to identify activities/areas of performance and workflow improvement. Actively participates in setting, monitoring and achieving goals for the Coding team.
Promotes and ensures collaboration between the CDI, Coding, Charge and Operations functions are optimal to achieve the excellence required.
Assists in the development and coordination of onboarding, orientation, training and continuing educational programs for fully remote and hybrid Coding staff.
Assists in meeting the DNFC and DNFB benchmarks of the organization; monitors the uncoded discharges to reduce accounts receivable days.
Assists Patient Financial Services with claims and denial processes as it relates to coding issues.
Assists the Coding/CDI Manager in the establishment, implementation, and maintenance of a formalized review process for Coding compliance, including formal review (audit) process; designs and uses audit tools to monitor the quality of Coding. Reviews external coder audits for agreement with findings and disputes findings with reviewer when not in agreement. Under the direction of the Coding/CDI Manger, responds to audit inquiries and findings as appropriate.
Performs data quality reviews to validate accurate code assignment (ICD-10-CM/PCS, CPT-4, HCPCS); modifier assignments; verifies Ambulatory Payment Classification (APC) group appropriateness; checks for missed secondary diagnoses and/or procedures and ensures compliance with inpatient/outpatient mandates and reporting requirements. Reports any aberrances to the Coding/CDI Manager.
Under the direction of the Coding/CDI Manager, assists in monitoring of case mix reports and the top DRG's to identify patterns, trends and variations in the facility's frequently assigned DRG groups; investigates and evaluates potential causes for changes or problems; takes appropriate steps in collaboration with the right staff to effect resolution or explain variances.
Assists and supports monitoring of outpatient reports and the leading medical visit, surgical service, significant procedure, and ancillary APCs assigned in the facility to identify patterns, trends, and variations in the facility's frequently assigned APCs; under the direction of the Coding/CDI manager, takes appropriate steps in collaboration with the right staff to effect resolution or explain variances.
Remains informed about transaction code sets, HIPAA requirements, and other issues impacting HIM functions; keeps abreast of new technology in coding and abstracting software and other forms of automation; and maintains current knowledge through certifications as appropriate. May perform the most technical, complex and difficult coding and abstraction work.
Required Skills
Required Experience