JOB DETAILS

Department: Professional Billing Coding

FTE: 1.00 (80 hours per pay period)

Workdays: Monday - Friday

Shift(s): Days

Shift Length: 8 hours

Location: Remote*

*Current List of non-MN States where Hennepin Healthcare is an Eligible Employer: Alabama, Arizona, Arkansas, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Mississippi, Nevada, North Carolina, North Dakota, New Mexico, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin.

Purpose of this position:

First line supervisory position typically responsible for supervising professional billing coding employees who are providing professional fee coding and billing services for provider services. Under the direction of the Physician Billing Manager. Position supports the coordination and development of processes which support Providers in creating clinical documentation which is an effective and consistent reflection of the care provided and ensures compliance, quality, and financial viability. Training, participating in evaluation of team and team processes, and supporting organizational documentation initiatives. Position requires considerable knowledge, experience, judgment, and ability to resolve problems related to coding and billing responsibilities of a work unit.

RESPONSIBILITIES

• Participates in the selection, training, and evaluation of staff engaged in the performance of Professional Fee Coding and Billing functions
• Reviews work for accuracy and conformance with departmental policies and procedures; tracks and monitors production goals and standards
• Determines priorities, schedules, and assigns work as required
• Develops, revises, and maintains work unit policies and procedures
• May compose correspondence or prepare reports on own initiative
• Maintains necessary office supplies, materials, or inventory
• Demonstrates maturity and accountability for job performance, supports the philosophy, objectives, and goals of the HIM department, and assesses areas of personal and professional growth
• Maintains licensure/certification and skills by obtaining required professional continuing education
• Perform other duties as assigned, but only after appropriate training
• Analyze provider documentation and billing practices through financial and coding activity reports, as well as documentation review, to identify potential opportunities for revenue capture and recognize areas of compliance concern
• Develop and execute departmental review projects with measurable financial and/or compliance goals per analysis findings
• Manage in-clinic review projects, including mitigation of risk, tracking and resolution of issues
• Organize, analyze, and present data for the purpose of working with Department Chiefs, Practice Managers and other stakeholders throughout the organization to outline and institute strategies for improvement
• Present education points and/or findings to Providers regarding coding and billing trends and related quality metrics
• Collaborate with key stakeholders to determine trends and educational needs
• Works with Health Information team to ensure standard processes related to preparing documentation efficiently and accurately for compliance with documentation requirements as defined by CMS, The Joint Commission and HCMC internal policies are supported in teaching and training of providers
• Works with manager to develop annual education plan based on analysis of reports for revenue opportunities, known compliance risks and documentation trends
• Conducts formal meetings and/or team meetings in lieu of Manager when requested
• Evaluates self and team processes to ensure individual, team and organizational goals are met
• Participates in creation of group training materials, leading organizational documentation initiatives, training and evaluation of Coding staff
• Other duties as assigned

QUALIFICATIONS

Minimum Qualifications:

• Associates degree in business and /or healthcare administration, Health Information Management or Health Information Technology
• Minimum of 2 years healthcare experience
• -OR-
• Bachelor’s degree
• -OR-
• Three (3) years external coding/reimbursement experience
• -OR-
• An approved equivalent combination of education and experience
• Certification/License Required: RHIT, RHIA, CCS, CCS-P or CPC

Preferred Qualifications:

• Prefer Bachelor’s in health related field
• E/M Auditing Experience
• Registered Health Information Administrator (RHIA) or Registered Health Information Technologist (RHIT) in an active status with the American Health Information Association (AHIMA) preferred

Knowledge/ Skills/ Abilities:

• Experience with Epic electronic medical record functionality and encoder and reimbursement systems recommended
• Must have extensive and demonstrated expertise in CPT-4, HCPCS, and ICD-CM coding classification systems
• Knowledge of state and federal legislation for HIPAA Privacy, medical record access, and regulatory and accreditation agencies
• Knowledge of current medical record technology, statistics, data presentation and reporting
• Organize, delegate and monitor work assignments
• Communicate effectively in oral or written communications; initiate, lead, mentor and coach staff