Supervisor Coding

Supervises all coding and charge entry functions. Finds resolutions of non-standard coding issues and assists in identifying necessary updates or revisions to optimize revenue generation and maximizing reimbursement. Offers expertise and guidance related to claim transactions, coding, auditing, reconciliation, compliance, as necessary or assigned. Provides education to departments and staff to ensure accurate coding, billing and to improve documentation to support all aspects of coding and billing. Recommends changes in procedures to affect savings in time, labor and costs to improve operating efficiency and the overall good health of the BTNRH revenue cycle.

SCHEDULE: Monday-Friday. Flexible hours 6:00a.m.-6:00p.m.

MAJOR RESPONSIBILITIES & DUTIES:

• Serves as the primary point person for all coding, data entry, and reconciliation of hospital generated or interfaced and manually entered charges, per Patient Financial Services (PFS) protocol and procedures, providing coding education as pertinent within PFS, the collective Revenue Cycle and to appropriate clinical staff.

• Oversees the interviewing, selection and evaluation of performance of coding personnel.

• Ensures proper supervision of daily activities of all personnel in the above functions, providing coaching, mentoring, and discipline as necessary, for optimal performance and an overall healthy revenue cycle.

• Reviews and analyzes coding submissions performed by the coding group and also billing from various departments and specialties within Boys Town National Research Hospital (BTNRH) as per the standards set forth in the BTNRH Coding Compliance Plan, reporting on the accuracy of procedure coding, ICD-10 coding and billing, to ensure legal regulations and procedural policies are being followed, while ensure the coding reflects the highest complexity and best financial outcome for BTNRH.

• Works collaboratively with medical, nursing, ancillary, charge reconciliation and code audit team to improve the quality of chart documentation, identifying any need to clarify documentation in the medical record.

• Communicates with clinical staff face to face, or use agreed upon querying mechanism, while serving as the primary resource to educate clinical staff on linking coding guidelines and medical terminology to capture the most accurate final code assignment.

• Performs monthly claim audits ensuring full revenue integrity is realized, inaccurate coding and/or billing services are identified, to include preparing reports of findings, and meeting with providers, nursing/ancillary staff, or leadership to provide education and/or training on accurate coding practices.

• Monitors statistical data based on review findings and concurrent reviews for trending purposes and summaries for Administration.

• Serves as the groups liaison and is the primary point of escalation with others within the Revenue Cycle, as well as an active resource to coding staff, physicians, clinicians, nurses, clinic staff, and business office in order to maintain observance of approved coding and reimbursement guidelines, Medicare and commercial carrier guidelines and in effort to obtain maximum reimbursement by identifying and offering ongoing educational needs related to coding and documentation optimization.

• Works to resolve non-standard surgery verification and coding issues with the PFS staff, clinic staff, third party payers, and patients.

• Performs coding and charge reviews necessary to appeal coding related denials in the most efficient and effective manner, as well as those requested through patient concerns/dispute process by comparing the charges against all necessary clinical documentation, looking for discrepancies and communicating findings to the appropriate leaders.

• Serves as resource to physician and clinical team members for ongoing educational needs related to coding by identifying inaccurate or under-utilized coding and/or billing services; preparing reports of findings, and meeting with providers, medical office staff or leadership to provide education and training on accurate coding practices

• Monitors statistical data based on review findings and concurrent reviews for trending purposes and compiling useful summaries for the Revenue Cycle leadership team.

• Offers assistance as needed to certified coding team to ensure timeliness and accurate charge submission throughout the organization by applying knowledge of ICD-10-CM, inpatient and outpatient coding guidelines and CPT format, guidelines.

• Tracks, trends and analyzes coding workflows and work, implementing changes when appropriate to fix issues, or offer more efficiency. This includes using system and workflow updates, education of staff and work with clinical teams and management to achieve set KPI and other metric goals within Patient Financial Services, focusing on effectiveness, efficiency, maximizing revenues and reimbursement.

KNOWLEDGE, SKILLS, AND ABILITIES:

• In depth knowledge of current Centers for Medicare and Medicaid Services, (CMS) requirements as well as Correct Coding Initiative, (CCI) edits, Diagnosis Related Group, (DRG) Hospital Acquired Conditions, (HAC's) and when applicable, National Coverage Determinations, (NCDs) and Local Coverage Determinations, (LCDs,) and overall healthcare coding and billing practices, while serving as the subject matter expert, in hospital coding.

• Knowledge of 3M coding products (APC, DRG, Core) and overall software functionality.

• Ability to safeguard the privacy of the medical information in the patient record, maintaining strict confidentiality of the patients medical and financial records.

• Ability to apply a thorough knowledge of medical terminology, abbreviations, anatomy & physiology, diseases and procedures to accurately review coding assignment and support staff.

• Ability to apply a thorough knowledge of ICD-10-CM, ICD-10-PCS, CPT-4, HCPCS, Revenue Codes, Coding rules and guidelines and proper sequencing to support and audit staff performance.

• Proficient use of Microsoft Outlook applications (Outlook, Word and Excel.)

• Ability to communicate clearly and concisely both orally and in writing with all staff, physicians, and patients in all aspects of the job to allow efficiency and promptness for patient care.

• Ability to manage staff and coordinate activities, organizing departmental workloads to comply with deadlines and priorities established by the Department Manager.

• Knowledge of claim forms and claims filing processes

• Ability to prepare various routine and recurring reports, understanding their content and how the data was pulled

• Possesses analytical skills necessary to perform accurate an extensive review on selected patient accounts and claims.

• Ability to coordinate and complete complex projects efficiently, effectively and on time.

• Ability to serve as a positive role model, supporting the mission of the organization.

REQUIRED QUALIFICATIONS:

• High school diploma or equivalent required.

• Minimum of 5 years experience in Facility and/or Professional coding or equivalent combination or education and experience required.

• A current Inpatient Coding Certification through AHIMA or AAPC required.

• Professional coding certification within two years of transfer or hire required.

• Minimum of 2 years direct supervisory or leadership experience required.

• Experience with software applications as they apply to the computerized patient record required.

PREFERRED QUALIFICATIONS:

• Associate or bachelor's degree in business, healthcare or related field preferred.

• EPIC and 3M experience preferred.

• Other Duties: This job description incorporates the essential functions and duties required for this position. However, other duties may be required and assigned at times and as determined by a supervisor in order to meet the needs of the organization.

• Serves as a role model in carrying out activities and behaviors that reflect the values and principles of the Boys Town mission.

PHYSICAL REQUIREMENTS, EQUIPMENT USAGE, WORK ENVIRONMENT:

• Position is relatively sedentary in a normal office administrative environment involving minimum exposure to physical risks. Will use office equipment such as a computer/laptop, monitor, keyboard, and a general workstation set-up.

Diversity is more than a commitment at Boys Townit is the foundation of who we are and what we do.

At Boys Town, we cultivate a culture of inclusion for all employees that respects their individual strengths, views, and experiences. We believe that our differences enable us to be a better team one that makes better decisions, drives innovation, and delivers better business results.

About Boys Town:

Boys Town has been changing the way America cares for children and families since 1917. With over a century of service, our employees have helped us grow from a small boardinghouse in downtown Omaha, Nebraska, into one of the largest national child and family care organizations in the country. With the addition of Boys Town National Research Hospital in 1977, our services branched out into the health care and research fields, offering even more career opportunities to those looking to make a real difference.

Our employees are our #1 supporters when it comes to achieving Boys Town's mission, which is why we are proud of their commitment to making the world a better place for children, families, patients, and communities. A unique feature for employees and their dependents enrolled in medical benefits are reduced to no cost visits for services performed by a Boys Town provider at a Boys Town location. Additional costs savings for the employee and their dependents are found in our pharmacy benefits with low to zero-dollar co-pays on certain maintenance drugs. Boys Town takes your mental health seriously with no cost mental health visits to an in-network provider. We help our employees prepare for retirement with a generous match on their 401K or 401K Roth account. Additional benefits include tuition assistance, parenting resources from our experts and professional development opportunities within the organization, just to name a few. Working at Boys Town is more than just a job, it is a way of life.

This advertisement describes the general nature of work to be performed and does not include an exhaustive list of all duties, skills, or abilities required. Boys Town is an equal employment opportunity employer and participates in the E-Verify program. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and/or expression, national origin, age, disability, or veteran status. To request a disability-related accommodation in the application process, contact us at 1-877-639-6003.