Summary
This is a 100% Remote Position
This position is looking for a candidate that has experience in supervising and experience with ASU Coding. This candidate will oversee the ASU Surgical Team for both HB/PB Surgical Coding.
This position manages Revenue Integrities Clinical Data Section, which is accountable for coding and abstracting the medical records of Provider Based practice outpatient practice clinic claims; preparing statistical analysis of medical records data; compiling, analyzing and summarizing data from medical records into various formats. The output of this Section is used for meeting hospital licensure requirements; financial and billing purposes, which includes the identification and determination of appropriate reimbursement under inpatient and outpatient prospective payment systems; maintenance of acceptable accounts/receivables and Pre A/R levels; compliance with internal and external regulatory agencies, such as Quality Improvement Organizations, the Centers for Medicare & Medicaid Services, and The Joint Commission.
Required Minimum Knowledge, Skills, and Abilities (KSAs)
- Education: Advanced education which should include communication and mathematical/statistical skills and/or extensive knowledge in organization, research and analysis normally acquired through the completion of Health Record Administration/ Technician /Science Bachelor's/Associate Degree program, preferred.
- License/Certifications: Certification in one of the following areas required: RHIA/RHIT, CCS, CPC. Skilled in ICD10 diagnosis and CPT coding and knowledge of Provider Based Billing practices.
- Experience: A minimum of two years prior successful supervisory experience required; Experience with EPIC, claim edit processes, encoder software and CDI programs, preferred.
- Full working knowledge of medical information and revenue cycle systems; Grouper and Severity of Illness Systems; medical record systems, medical terminology, anatomy, physiology, pathophysiology, microbiology, and pharmacology; State, Federal and Joint Commission requirements pertaining to medical records; Provider Based payment systems, preferred.
- Demonstrated abilities to correctly interpret and apply Federal regulations and PRO requirements in the interpretation of various billing guidelines (i.e., medical necessity, resident supervision policies, correct coding initiative, etc.). Ability to direct concurrent and retrospective coding reviews and provide physician education, required.
- Effective skills in leadership, communications, coaching, planning, motivation, and establishing effective working relationships with all levels of staffing in the organization.
Additional Information
MaineHealth is a health system whose members and affiliates include hospitals, physician practices, long-term care facilities, home care agencies, and support services. Learn more about this system at www.mainehealth.org.
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