HIM Coding Manager at Northeast Georgia Health System, Inc.

Posted in Other 12 days ago.

Location: Gainesville, Georgia





Job Description:

Improving the health of our community in all we do



Northeast Georgia Health System (NGHS)is a non-profit community health system on a mission of improving the health of our community in all we do. Our team cares for more than 1 million people across the region through four hospitals and a variety of outpatient locations. Northeast Georgia Medical Center (NGMC) has campuses in Gainesville, Braselton, Winder and Dahlonega - with a total of more than 700 beds and more than 1,100 medical staff members representing more than 50 specialties. NGHS also encompasses Northeast Georgia Physicians Group, a multi-specialty group with more than 65 locations, and The Heart Center of Northeast Georgia Medical Center, a cardiology practice with more than 15 locations.


NGHS



HIM Coding Manager - Gainesville




Full Time - 8:00am-4:30pm




Job Summary:



This position reports to the Director of Health Information Management & Coding and is responsible for developing, implementing and managing the efficiency and effectiveness of the Coding area. Oversee the quality and productivity to include inpatient and outpatient coding and ensuring accuracy of coded and abstracted information for all patient types. Facilitate communication between the Coding functions and others within the Revenue Cycle.


Works effectively with physicians to ensure appropriate clinical documentation supporting coding accuracy and provides ongoing education to coders, as well as, other clinical staff. Serves as educational resource for ICD-10 implementation. Is accountable for coding and regulatory compliance.



Minimum Job Qualifications:



  • Five years of coding experience in ICD-10 and CPT4 coding.

  • Professional licensure in HIM; RHIA or RHIT and CCS Certification, AHIMA-Certified ICD-10 Trainer

  • Supervisory/Management experience preferred.

  • Must have working knowledge of DRG's, APC's and regulatory compliance.


Preferred Education requirements:



  • Bachelor's degree




Job Specific and Unique Knowledge, Skills and Abilities



  • Must have the ability to work under pressure with time constraints and have the following skills and aptitudes:

  • Strong knowledge base in complete and accurate clinical documentation in all healthcare settings and for all healthcare disciplines.

  • Strong knowledge base and experience in coding and billing practices.

  • Knowledge of the conventions, rules, guidelines for multiple classification systems.

  • Knowledge of multiple regulations, standards, policies, and requirements pertaining to clinical documentation, coding, and billing. Knowledge of multiple third-party payer requirements.

  • Knowledge of multiple reimbursement systems.

  • Ability to establish rapport with physicians and other healthcare practitioners.

  • Ability to accurately interpret and implement regulatory standards. Ability to interpret legal requirements.

  • Strong managerial, leadership, and interpersonal skills. Strong analytical and problem-solving skills.




Essential Tasks and Responsibilities



  • Acts and leads in a manner that is reflective of the philosophy, vision and values of NGHS. Integrates these values throughout all initiatives and efforts.

  • Uses a proactive leadership style to model and promote a culture of trust and communication. Seeks suggestions and input from staff and colleagues. Promotes an active participation of all staff in decision that affect them.

  • Holds all staff members accountable for following and adhering to all applicable rules, regulations, laws and guidelines.

  • Oversee and coordinate all formal communication with coders and other NGHS staff.

  • Oversee and monitor the development and implementation of the electronic medical record compliance program as it relates to coding processes.

  • Work closely with other department Managers to ensure an efficient and effective flow of information leading up to and following the coding function.

  • Encourages personnel to attend educational opportunities relevant to their position and supports their attendance.

  • Promotes a service-oriented culture within the organization and assures satisfaction with the quality and amount of support provided for departmental functions, initiative and projects.

  • Ability to intervene in an accurate and timely manger when pertinent information required allowing efficient work flow process.

  • Researches and recommends various technology tools available to support HIM initiatives as it relates to coding.

  • Responsible for the supervision, coordination, and processing functions of the coding area to promote productivity and data integrity.

  • Ensure that regular quality reviews and evaluation of required documentation, coding and abstracting accuracy.

  • Ensure that coding consultants, and other contracted entities understand and agree to adhere to official coding guidelines and practices.

  • Maintain all coding information and provide updated manuals, resources, and other coding materials.

  • Communicates effectively with coding staff to ensure patient satisfaction.

  • In addition to the above criteria, the Supervisor will be responsible for and must be proficient in all job duties of a Coder.

  • Maintain coding DNFB, productivity and quality information and provide trended data on a monthly basis to Director.

  • Serve as the coding advisor to individuals within the Organization.

  • Responsible for the direct supervision of coding staff and all coding related functions in the area.

  • Serves as the 1st contact for coding related issues.

  • Responsible for staffing the area for 24/7 coverage 365 days per year.

  • Serves as the primary support for all coding related system issues and communicates with ITS to ensure resolution.

  • Coordinate and ensure that all coding is completed within standard timeframe post discharge and/or ancillary service.

  • Collaborate with the Auditor/Educator as educational and training program regarding technical coding and clinical topics to the coding and clinical documentation improvement staff.

  • Assist Auditor/Educator in providing and educating coding staff with October and January code changes, as needed.

  • Conduct monthly Coder meetings to include formal education.

  • Compare coding and reimbursement profile with national and regional norms to identify variations requiring investigation.

  • Review claim denials and rejections pertaining to coding and medical necessity issues and implements corrective action as appropriate. Reports up to Manger any actions taken.

  • Responsible for and must be proficient in all job duties of a Coder and Auditor/Educator.

  • Ensure the appropriate dissemination and communication of all regulation, policy, and guideline changes.

  • Participate in the development of goals and objectives for the Department, related to coding, as well as short-term and long-range planning.

  • Develop, interpret, revise and implements policy and procedures for both coding and operations staff.

  • Participate in preparing Department budget specific to coding and manage area within budgeted guidelines.

  • Interview and hire coding staff with input from the Auditor/Educator.

  • Mentor staff on a daily basis and follow progressive discipline where indicated.

  • Works with Director to resolve discrepancies or staffing issues and addresses non-compliance to policies and/or procedures in a timely manner. Councils staff and administers corrective action as needed.

  • Conducts staff performance evaluations. Seeks input from Director, if needed.

  • Utilizes time management skills to ensure completion of daily processes.

  • Ensure thorough and appropriate documentation for all assigned staff is being maintained.

  • Maintains professional development and growth through professional affiliations, seminars and workshops to keep abreast of trends in Coding.

  • Assists Director with management/operation of the HIM Department.

    • Responsible for operation of the department in Director's absence.

    • Attends meetings throughout the organization and represents the Director as assigned.

    • Completes all employee reports and records according to established time frames: Success Reviews, Time Cards/Payroll Records, Disciplinary Actions, and Personnel Action Forms.

    • Serve as the key point person and/or assist, as needed, with HIM related complaints received by other departments. Is responsible for resolving complaints and following up with all parties involved.



Since first opening its doors in Gainesville in 1951, Northeast Georgia Medical Center has added hospital campuses in Braselton, Barrow and Dahlonega - and become Georgia's most awarded hospital. Some recognitions include being named to these lists:


America's 50 Best Hospitals- Healthgrades


100 Top Hospitals- Truven Health Analytics


100 Hospitals with Great Heart Programs- Beckers Hospital Review


America's Top Quality Providers- Carechex


Atlanta's Top 150 Workplaces- Atlanta Journal-Constitution


Healthcare's Most Wired Hospitals and Health Systems- Hospitals & Health Networks magazine


NGMC has also been recognized in recent years as Georgia's #1 Hospital for overall hospital care, overall surgical care, heart care, orthopedic surgery, women's care and more.