Responsible for coordinating and supervising the work of the medical coding staff, which includes handling and reviewing patients' medical records, recommending the correct code, discovering gaps in patients' records, and delivering of the summary to individual clinicians and their leaders explaining necessary changes. De monstrate the company's core values of respect, honesty, integrity, diversity, inclusion, and safety.MINIMUM
High School Diploma or GED
5+ years coding auditing and medical coding experience
AAPC/AHIMA certification
Thorough knowledge of Medicare reimbursement guidelines and medical terminology
Strong analytical, organizational, computer, and excel skills
Highly self-motivated with ability to work independently and with a team, prioritize, and handle multiple responsibilities to meet deadlines
Ability to identify opportunities for process improvement and implement solutions
Excellent presentation, verbal, and written communication skills
Attention to detail and ability to maintain a high degree of confidentiality
Knowledge/understanding of healthcare compliance industry and federal laws/regulations
Demonstrated coaching and influencing skills
DESIRED
Bachelor's Degree
Any compliance experience
Oversee the day-to-day operations of the coding department and ensures that work assignments are completed on schedule by providing effective monitoring to both quantity and quality of workflow
Supervise all functions of the medical coding department, including maintaining and updating the coding process, monitoring budget, taking part in the development of programs and process improvement initiatives, and carrying out auditing duties
Perform tasks in accordance with company-wide project specific guidelines and standard coding practices acceptable in the industry
Research guidelines/regulations such as Medicare transmittals/Manuals, LCDs, NCDs and CMS/OIG guidelines pertinent to assessments
Adhere to AAPC and/or AHIMA ethical coding standards and remain abreast of changes to coding standards/regulations; Carryout thorough and consistent review of all coding, including studies that were outsourced
Oversee coding/documentation reviews and audits to assess compliance and accuracy with ICD-10/CPT/HCPCS codes, modifiers, updated coding standards, and other regulatory guidelines/requirements
Coordinate external coding compliance audits, including sample selection, communications with external auditor and internal stakeholders, reviewing/analyzing audit results, and coordinating audit completion and follow-up
Provide clear and strategic communication on medical coding process improvements as appropriate/approved to the team and ensure implementation
Serve as a Kroger Health resource to improve coding and documentation processes both internally and externally acting as the liaison with coding vendors and internal coders
Participate in a variety of meetings and work groups to integrate activities, assist in creating or/and reviewing medical coding related Work Instructions and Standard Operating Procedures, communicate issues, obtain approvals, resolve problems and maintain specified level of knowledge pertaining to new developments, requirements, and policies
Perform other related duties as assigned, including, but not limited to assessment of coding applications/tools, creating, documenting, and maintaining medical coding related items, including Change Request Logs, and Global Coding Guidelines
Work collaboratively with the Data Management department to ensure coding deliverables are achieved in a timely manner and identify and communicate emerging issues and trends to stakeholders
Evaluate quality of clinical documentation to assess quality of data being submitted and/or reported, chart review trends, and audit findings
Direct investigation of escalated coding, billing, and documentation compliance matters
Supervise and coach direct reports in the performance of their duties; complete performance reviews and provide feedback to direct reports
Must be able to perform the essential functions of this position with or without reasonable accommodation
