Supervisor - Professional Coding Services - Lancaster/Lebanon County - Full Time - Days

Stevens, PA | Professional | Tracking Code: 55733

Position Summary:

General Summary:


Under the general supervision of the Director Patient Financial Services - PB, provides oversight and direction of System-wide Professional Coding to implement and maintain standardized processes and compliant coding guidelines. Coordinates processes and/or third-party contracts regarding coding. Oversees, assigns coding staff and/or participates in reimbursement audits across the System. Monitors and addresses coding compliance issues and trains workforce in coding compliance matters. Works with other System departments to ensure a cohesive team effort in addressing coding and/or coding compliance matters. Provides direct supervision of the assigned coding, billing/insurance clerks, and claims review analysts and has oversight of and responsibility for 10 to 30 FTE.


Duties and Responsibilities:

1 Establishes, monitors and ensures coding productivity and timeliness.
2 Provides PCS operational oversight as needed; and monitors daily work activities including work queues and dashboards.
3 Develops and coordinates educational and training programs regarding elements of professional coding standardization and compliance program, such as appropriate documentation and accurate coding, to all appropriate personnel, including PCS coding staff, physicians, billing personnel and ancillary departments.
4 Recommends staffing levels, selects and assigns professional coding services staff, evaluates performance, evaluates/tests competencies (as applicable), provides orientation, training and continuing education of professional coding services staff, and initiates or makes recommendations for personnel actions.
5 Coordinates final approval for coders to work from home, including management of Off Site/Home Contracts to ensure compliance and full understanding of all HIPAA regulations regarding working from home, and having home access to the WellSpan Network.
6 Establishes and communicates to appropriate coding staff a defined daily process for monitoring and working professional charges
7 Conducts trend analysis to identify patterns and variations in coding practices, communicating findings to necessary parties.
8 Assists the Director of Patient Financial Services - PB in the development, implementation and analysis of protocol standards/work methodology consistent with industry trends and departmental objectives.
9 Keeps the Director of Patient Financial Services -PB informed of all coding-related issues
10 Conducts internal investigation of changes in coding practices or reports of other potential problems pertaining to coding, communicating findings to Director Patient Financial Services-PB and Corporate Compliance.
11 Initiates corrective action to ensure resolution of problem areas identified during an internal investigation or auditing/monitoring activity across Professional Coding.
12 Represents PCS on various committees, as assigned
13 Acts on behalf of the Director, as needed, and serves as a liaison between PCS and other departments to ensure a consistent flow of information.
14 Assists with system conversion activities as needed
15 Provides PCS operational supervision (in absence of Director), as needed.
16 Receives and investigates professional coding compliance violations and communicates this information to the Director of Patient Financial Services – PB and the Corporate Compliance Officer.
17 Ensures the appropriate dissemination and communication of all regulations, policy and guidelines changes. Works with WellSpan entities to ensure coding software is up to date, facilitate fee analysis and makes recommendations regarding the addition of new codes and fees.
18 Serves as a resource for Compliance Office, department managers, staff, physicians, and administration to obtain information on accurate and ethical coding and documentation standards, guidelines and regulatory requirements.
l coding and documentation standards, guidelines and regulatory requirements.

Required Skills

Associate's Degree in a health services discipline required
Certified Procedural Coder (CPC) or Certified Coding Specialist-Physician (CCS-P) required

Required Experience

5 years of coding and reimbursement experience required
Inpatient/outpatient coding systems and coding compliance preferred
Extensive knowledge of ICD-9/ICD-10 and CPT coding principles and guidelines
Extensive knowledge of reimbursement systems, as well as federal, state and payer-specific regulations and policies pertaining to documentation, coding and billing
Extensive knowledge of Best Practice Standards of Coding and identification of reliable compliant reference sites and/or materials
Strong interpersonal skills, presentation/instructional skills
Excellent written and oral communication skills
Excellent analytical skills.
Supervisory experience required

 


Quality of Life

WellSpan Health is an integrated health system that serves the communities of central Pennsylvania and northern Maryland. The organization is comprised of a multispecialty medical group of more than 1,200 physicians and advanced practice clinicians, a regional behavioral health organization, a home care organization, six respected hospitals, more than 15,000 employees, and 140 patient care locations. WellSpan is a charitable, mission-driven organization, committed to exceptional care for all, lifelong wellness and healthy communities. We are committed to transforming the health of the communities we serve and to educating the next generation of clinicians, staff and leaders.

Quality of Life
Quality of Life

Lancaster City was the capital of Pennsylvania from 1799 to 1812. Today, Lancaster County includes a vibrant downtown business district, desirable suburban neighborhoods and sprawling agricultural farms. Life in Lancaster County offers affordable housing, options for higher education, a thriving arts and cultural community, historical attractions, parks and recreational resources, an independent professional baseball team, fine dining and more. When visiting Lancaster, one can't help but recognizing the influence of the Pennsylvania Dutch — farm-to-table and beyond.

Conveniently located in southcentral Pennsylvania, Lancaster is within an easy commute to major cities and has ready access to public transportation. Residents can find local employment in healthcare, tourism, public administration, manufacturing, and both professional and semi-professional services. (Patient population: 535,000)

Equal Opportunity Employment

WellSpan Health is an equal opportunity employer. Employment selection and related decisions are made without regard to sex, race, age, disability, religion, national origin, color or any other protected class. WellSpan Health does, however, have a tobacco-free/nicotine-free hiring policy.

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