Careers >> HIM Manager, Professional Coding Support/PCS Supervisor
HIM Manager, Professional Coding Support/PCS Supervisor
Summary
Title:HIM Manager, Professional Coding Support/PCS Supervisor
ID:113292
Department:Health Information Management
Location:37987
Description
ONSITE POSITION
contract at this time, and has potential to extend.

will also share time between the Pasadena location and the Downey location.
Cover for other Coding Managers as needed.
*** No hands on coding in this role, review coding only.
This role is helping with the workload, on site will be required.

Education:
Bachelors-required

Certification/Licence(s):
CCS and RHIT or RHIA, .

Basic Qualifications:
Coding Management experience required, will manage coding staff, union workers.
• Minimum three (3) years of experience supervising a multidisciplinary coding staff of non-exempt and entry level employees.
• Minimum five (5) years of experience implementing coding policies and regulations as well as applying coding procedures.

Additional Requirements:
• Possess proficiency in a variety of software applications such as MS Excel, Word and PowerPoint.
• Able to effectively coordinate multiple projects, use time management skills and exercise independent judgment.
• Able to adapt to shifting priorities; perform as a team player, and operate in a tactful and diplomatic manner.
• Possess strong customer service and interpersonal skills required to communicate effectively internally and externally with all levels of management.
• Must be able to effectively work in a Labor/Management Partnership environment

Bears regional responsibility for managing hospital coding operations, to include:
assessing operational staffing needs in order to ensure the compliance and timeliness of coded patient records;
performing, reviewing and assisting with coder education, audits and training needs in order to ensure the quality of same records;
and developing and maintaining effective policies, procedures, systems and working relationships with other regional and hospital departments, medical staff and external regulatory and reporting entities while functioning as the coding liaison and coding subject matter expert.
Accomplishes assigned daily management functions of the regional coding operations department, in order to ensure the quality of coded patient records through performing, reviewing and assisting with coder education, audits and training needs
• Utilizes all available management tools such as the inventory report to continuously assess daily departmental operational needs in order to ensure that staffing needs are adequate for completion of coded patient records according to established guidelines and within established timeframes.
• Manages, coordinates and provides leadership to the coding and coding support staff.
• Conducts performance evaluations and resolves grievances for direct reports and other assigned staff.
• Manages and resolves human resource, employee and department safety and risk management issues.
• Ensures effective use of patient health information data by providing statistical analysis and reports, and by consulting with other departments who utilize such data for management, quality, utilization, research, and other vital functions.
• Ensures that goals and services provided by Regional Hospital Coding Operations are aligned with organizational priorities.
• Coordinates, and implements projects and/or programs to improve the quality and cost-effectiveness of coding operations.
• Provides effective financial management and efficient use of resources.
• Participates in the budget planning and preparation process of assigned work units to meet fiscal goals.



Work Experience 
Four or more years in a revenue cycle role including experience with integrated health care delivery systems, multi-facility and multi-specialty health systems.
Four or more years experience in professional coding with audit experience and a focus in Regulatory and billing requirements for State and Federal agencies, Worker’s Compensation, Third Party Liability and Commercial carriers.
Minimum two years experience in a relevant management level position.
Demonstrated experience in coding/service capture, internal quality, information systems, operations improvement, reengineering and project management.
Excellent working knowledge of revenue cycle operations and insurance benefits, professional coding, state and federal regulations and product development.
Excellent communication skills (written and verbal) with the ability to manage both through direct reporting relationships as well as through influence and collaboration. 


Functional/Technical Knowledge & Skills 
• Ability to lead and achieve success in a consensus based environment 
• Ability to analyze trends, develop and maintain performance goals 
• Skilled in coaching, counseling and developing other to achieve operational objectives including teaching the fundamentals of revenue cycle operations and objectives. 
• Skilled in team building, team participation and achieving organizational success 
• Excellent written, oral and interpersonal (negotiating and listening) communication skills are required for interacting with all levels of health care professionals within hospitals, medical groups and health plans. 
• Proficiency in all Microsoft computer applications (Excel, Powerpoint and Access) and other job-related networks and software. 

Industry Knowledge 
• Operational knowledge of hospital and/or physician clinic based revenue cycle required 
• Operational knowledge of professional services coding and billing in a multi-specialty environment 
• Knowledge of general business concepts including financial management organizational behavior and personnel/labor laws and regulations 
• Knowledge of government and other payer coding, billing and collection rules and regulations.• 


Job Description:
The Manager, Professional Coding Support Services is a management position responsible for supporting the Director, Professional Fee Support Services regarding the operations success of the Professional Coding Support Services (PCSS) unit.
The individual is responsible for assuring day to day operations for professional coding services, supporting Client’s ability to produce compliant coded healthcare data and ensure the sustainability of the revenue cycle.
Specifically, the Manager, Professional Coding Support Services is responsible for the direct oversight of the PCSS Unit inclusive of: 
• Manual Abstraction and Coding of Medical Services with the application of appropriate CPT, HCPCS, ICD-10-CM diagnosis codes and modifiers. 
• Ingenix/HealthConnect Coding edit correction, with assignment of accurate CPT, HCPCS, ICD-10-CM diagnosis codes and modifiers 
• Management and oversight of work queues in KP Health Connect to assist in cycle times within defined parameters 
• Issue identification and corrective action plan development to resolve errors resulting in increased cycle times 

Major Responsibilities (In order of importance, Estimated Percentage of Time (Range) 
1. Management and Team Building 
• Provides day-to-day oversight of staff and processes including, but not limited to: 
• Securing all technical and system resources 
• Staff recruitment 
• Professional coding services work migration 
• All other activities associated with creating a robust, high functioning professional coding and edit correction unit 
• Responsible for the supervision of the Professional Fee Support Services unit inclusive of: 
• Manual abstraction and coding of medical services with the application of appropriate CPT, HCPCS, ICD-10-CM diagnosis codes and modifiers 
• Ingenix/HealthConnect coding edit correction, with assignment of accurate CPT, HCPCS, ICD-10-CM diagnosis codes and modifiers 
• Management and oversight of work queues in HealthConnect to assist in cycle times within defined parameters 
• Issue identification and corrective action plan development to resolve high volume errors resulting in increased cycle times 
• Responsible for hiring, coaching, developing, disciplining and terminating staff as necessary 
• Develops subordinates and establishes a climate for personal growth and development 
• Identifies education and training requirements and works with leadership to develop effective training programs for immediate subordinates encompassing best practice industry standards 

• Works with direct reports to develop tactical and strategic solutions to meet the goals of this position 
• Partners with labor and human resources to develop and execute a labor strategy that supports revenue cycle objectives, and maintains an effective working relationship with labor to address LMP-related issues 
• Helps to foster an environment and culture within the Revenue Cycle that is built upon open communication, trust and honesty, and collegiality 
40% 

2. Strategic Planning, Influence and Alignment 
• Provides input into strategic planning processes in support of new initiatives and technologies to enhance the performance of the Professional Coding Support Services Unit and Northern California Revenue Cycle 
• Contributes input and data as needed to support the Director Professional Fee Support Services in developing short and long range plans regarding coding and documentation issues 
• Provides day to day support in the development and execution of strategic vision and supporting initiatives, as agreed to with the Director 
• Collaborates with key stakeholders to ensure that operations and processes remain consistent and emulate best practices 
• Develops strategic planning processes in support of new initiatives and technologies to enhance the performance of the Revenue Cycle 
• Supports the organization in the development of uniform Revenue Cycle policies and procedures 
15% 

3. Leadership and Consultative Experience 
• Serves as a member of the Professional Fee Support Services (PCSS) unit leadership team focusing on coding and documentation issues not limited to: 
• All regulatory and compliance requirements 
• Coding and service capture practices 
• Documentation standards 
• Provider billing and credentialing 
• Statement of financial responsibility 
• Cost share allocation 
• Patient privacy 
• Formulates and makes recommendations to leadership on polices and practices relating to PCSS operational improvements 
• Identifies opportunities for process improvement, and implements them by engaging the Director, Professional Fee Support Services and key stakeholders 
• Monitors and assists with the development of action plans to proactively position the PCSS to effectively incorporate changes in legislation and accreditation standards that impact the revenue cycle
• Assists with the development of business cases, in conjunction with other relevant subject matter experts, to support strategic initiatives relating to the PCSS 
15% 

4. Coordination and Project Management 
• Responsible for the identification of key revenue cycle initiatives for the Professional Coding Support Services (PCSS) unit 
• Implements and oversees initiatives within the PCSS, including the identification and management of necessary resources 
• Analyzes issues to develop recommendations related to course of action and resource requirements in order to achieve desired outcomes. 
• Supports the Director, Professional Fee Support Services regarding the creation and implementation of an appropriate infrastructure with training and communication teams to ensure that key information is being received by impacted staff 
10% 

5. Metrics and Reporting 
• Monitors operational performance on a daily, weekly and monthly basis to ensure that departmental objectives are being achieved 
• Proactively responds to revenue cycle metric requirements on a daily basis 
• Creates and supports analysis and organized feedback to the Medical Centers and regional stakeholders, identifying opportunities for improving data capture timeliness, accuracy and completeness 
10% 

6. Compliance, Quality Assurance and Quality Control 
• Facilitates compliance with administrative/legal requirements and governmental regulations as it relates to revenue cycle operations. 
• Monitors departmental compliance with internal controls (Sarbanes Oxley) and develop remediation plans to address identified control weaknesses. 
• Supports Client's Revenue Cycle policies and procedures. 
• Accountable for revenue cycle data quality monitoring and related training. 
• Ensures all practices relating to the acquisition and maintenance of information comply with federal, state and hospital regulations, policies, and procedures. 
10% 
Total 100% 
 
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