Decatur Memorial Hospital
To improve the health of the people of Central Illinois.
Decatur Medical Group (“DMG”) consists of physician and non-physician practitioners providing professional services to Decatur Memorial Hospital patients. The Professional Services Coding Supervisor (“PS Coding Supervisor”) provides documentation review, coding and billing services in accordance with DMG’s compliance plan, following its policies and procedures, official and regulatory coding guidance. Understanding and accurate use of approved coding guidelines is paramount to successful performance in this position.
Essential Functions and Job Duties
The PS Coding Supervisor is responsible for reviewing the medical record to independently determine the appropriate CPT / HCPCS procedure codes, modifiers, and ICD-10-CM (diagnosis) codes are supported by medical record documentation for submission to commercial and government payors. DMG’s use the information provided by the coder to obtain: correct reimbursement from all payors, provider compensation, financial planning, contracting, and performance improvement activities. The PS Coding Supervisor is also responsible for performing quality assurance reviews on PS Coding staff and assisting with billing follow up and denial management requests when needed.
- Provides daily supervision and oversight of professional services coders. This includes setting priorities to meet revenue cycle goals.
- Identifies and assigns appropriate CPT and ICD-10-CM codes for reimbursement, research, and compliance in accordance with coding guidelines.
- Complies with all federal, local and other legal requirements as they relate to medical coding practices.
- Reviews all patient encounters involving a professional service and assigns and sequences all diagnoses and procedure codes to the highest level of specificity documented in the provider notes.
- Observes confidentiality and safeguards all patient related information.
- Accurately assign Evaluation & Management (“E/M”) services after review of the provider’s documentation in accordance with the 1995 or 1997 E/M documentation guidelines.
- Perform quality assurance reviews on all PS Coders and provide education to help coders maintain accuracy standards.
- Report accuracy and productivity of all PS Coders to the HIM Director.
- Complete coding tasks while maintaining the required accuracy and productivity standards.
- Communicates in a positive and professional manner with visitors, physicians, and hospital staff.
- Maintains an optimal working relationship with peers, other hospital departments, and physicians.
- Exhibits understanding of CARES and the hospital mission statement.
- Attends continuing education classes to maintain coding proficiency in ICD-10-CM, CPT/HCPCS, and other areas as deemed necessary by management.
- Utilize DMG’s Epic electronic health record (“EHR”) and other DMG and DMH documentation and billing systems to abstract and code all professional services, including data entry of codes.
- Use professional services encoder software to determine RVU values for correct coding assignment and modifier use.
- Participate in DMG’s coding quality reviews as deemed appropriate by the HIM Director.
- Attend continuing education classes to maintain coding credential and continually improve proficiency in areas of coding that include but are not limited to CPT, ambulatory surgery, surgical specialties, E/M assignment, ICD-10-CM and other specialties as required.
- Interpret coding rules and general policies in addition to determining appropriate conclusions.
- Complete administrative activities such as time reporting, productivity reporting and expense reporting as necessary and in accordance with established policies and deadlines.
- Comply with DMG’s policies regarding the use and disclosure of protected health information which includes accessing and using protected health information only to the extent necessary to fulfill the above-mentioned responsibilities.
Education and/or Other Requirements
- Minimum High School Diploma or equivalency. College degree and / or extended education in an allied health field preferred.
- Possess an established coding credential from AAPC (CPC) or AHIMA (CCS-P) pertaining to professional fee coding and remain in good ethical standing, by obtaining the necessary continuing educational certification requirements.
- Five (5) to eight (8) years’ experience in healthcare billing, coding and / or reimbursement follow up activities for professional coding services.
Full Benefits Package available. Salary based on experience.
Instructions for Resume Submission: