Description
JOB SUMMARY:
Leads coding and documentation for accuracy and proper documentation. Assesses compliance with all regulations of federal and state agencies and third party payers. Directly supervises staff and ensures quality standards are met.
KEY RESPONSIBILITIES: - Conducts quality analysis of coding and abstracting to include reviews for accuracy, completion and compliance with regulations.
- Serves as a resource to staff, providers and other departments for coding related issues.
- Analyzes data to determine patterns of denials/errors and provides analysis.
- Ensures quality standards are met.
- Monitor eStar work queues related to Pathology charges
- Actively maintain continuing education credits- 18 annually
- The responsibilities listed are a general overview of the position and additional duties may be assigned.
TECHNICAL CAPABILITIES:
MEDICAL CODING (EXPERT): - The transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes.
LEADERSHIP (INTERMEDIATE): - Formulates a vision while motivating & guiding employees promoting engagement. Leaders state precise goals, ensures the commitment of individuals to those goals, defines the methods of measurement, and provides the incentive to accomplish measurable outcomes.
OPERATIONS PLANNING (INTERMEDIATE): - Anticipates resource needs to meet objectives and implements appropriate processes.
PEOPLE MANAGEMENT (INTERMEDIATE): - Interacting, communicating, building relationships and developing employees.
COMPLIANCE (INTERMEDIATE): - Understanding the rules, regulations, sanctions and other statutory requirements, guidelines and instructions relating to governing bodies and organizations, both internally and externally.
BUSINESS RESULTS (NOVICE): - Ability to achieve business results while focusing on quality, customer satisfaction, and stewardship.
QUALITY MANAGEMENT (NOVICE): - Developing a systematic process of checking to see whether a process or service is meeting specific requirements.
CORE ACCOUNTABILITIES: - Organizational Impact: Directs activities to achieve operational plans with some near term effect on results of the department/area.
- Problem Solving/ Complexity of work: Identifies issues, gathers facts to resolve technical and operational problems.
- Breadth of Knowledge: Applies in-depth knowledge and skills of a professional/technical area and basic management knowledge to manage the work of the team.
- Team Interaction: Leads a complex department with a focus on implementation. Typically executes on a short to medium term strategies.
CORE CAPABILITIES:
SUPPORTING COLLEAGUES (M2):
- - Develops Self and Others: Invests time, energy and enthusiasm in developing self/others to help improve performance and gain knowledge in new areas.
- - Builds and Maintains Relationships: Maintains regular contact with key colleagues and stakeholders using formal and informal opportunities to expand and strengthen relationships.
- - Communicates Effectively: Recognizes group interactions and modifies one's own communication style to suit different situations and audiences.
DELIVERING EXCELLENT SERVICES (M2):
- - Serves Others with Compassion: Seeks to understand current and future needs of relevant stakeholders and customizes services to better address them.
- - Solves Complex Problems: Approaches problems from different angles; Identifies new possibilities to interpret opportunities and develop concrete solutions.
- - Offers Meaningful Advice and Support: Provides ongoing support and coaching in a constructive manner to increase employees' effectiveness.
ENSURING HIGH QUALITY (M2):
- - Performs Excellent Work: Engages regularly in formal and informal dialogue about quality; directly addresses quality issues promptly.
- - Ensures Continuous Improvement: Applies various learning experiences by looking beyond symptoms to uncover underlying causes of problems and identifies ways to resolve them.
- - Fulfills Safety and Regulatory Requirements: Understands all aspects of providing a safe environment and performs routine safety checks to prevent safety hazards from occurring.
MANAGING RESOURCES EFFECTIVELY (M2):
- - Demonstrates Accountability: Demonstrates a sense of ownership, focusing on and driving critical issues to closure.
- - Stewards Organizational Resources: Applies understanding of the departmental work to effectively manage resources for a department/area.
- - Makes Data Driven Decisions: Demonstrates strong understanding of the information or data to identify and elevate opportunities.
FOSTERING INNOVATION (M2):
- - Generates New Ideas: Proactively identifies new ideas/opportunities from multiple sources or methods to improve processes beyond conventional approaches.
- - Applies Technology: Demonstrates an enthusiasm for learning new technologies, tools, and procedures to address short-term challenges.
- - Adapts to Change: Views difficult situations and/or problems as opportunities for improvement; actively embraces change instead of emphasizing negative elements.
BASIC QUALIFICATIONS:
- Bachelor's Degree (or equivalent experience) - required
- 5 years relevant coding experience- required
- 3 years relevant management experience - preferred
- Licensed Discipline Specific - required
- CPC or CPC-H , CCS or CCS-P -preferred
- Coding experience in multi-specialty pathology preferred
- Experience with Cerner CoPath Plus and Epic eStar preferred