Job Description

Overview

Manager Centralized Coding Services

Full Time, 80 Hours Per Pay Period, Day Shift

Covenant Health Overview:

Covenant Health is the region’s top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area’s fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area’s largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes “Best Employer” seven times.

Position Summary:

Oversees all activities of daily operations and supervision of employees of the Corporate Coding department at Covenant Health. This position requires a unique skill set including extensive computer and MIS expertise (at a conceptual level) including, but not limited to: computer systems and software, information security, healthcare systems, data quality, protection of patient privacy, data display, design, linkage, and archiving/retrieval of information. Monitors the following on a daily basis to ensure facility goals are met and to prevent delays that affect the hospital’s financial performance: all unbilled accounts receivable claims for all coding deficiencies including those claims that have failed edits and are in need of correction.

Instills an equal appreciation in Coding personnel for complete and accurate information and the financial and clinical ramifications of all work processes. Responsible for ensuring practices in the department meet all the Joint Commission and state standards. Works closely with IS on system selection and implementation that affect the area. Maintains optimal communication links with Integrity Office, Clinical Documentation Improvement, Quality Management, Case Management and KBOS. Customer service mentality is crucial, as is a good working relationship with the medical staff.

Responsibilities include interviewing, hiring and training new employees; and developing a consistently reliable service that adheres to quality, budget, and timeliness. Establishes and monitors individual employee’s quality and quantity standards assuring these standards are consistently met. Develops, and ensures adherence to enterprise-wide policies, procedures, guidelines, and training manuals. Establishes, implements, and enforces standards for quality and timeliness based on customers' needs and in accordance with the Joint Commission, HIPAA, CMS and other related State and Federal guidelines.

Responsible for the coding for the following entities: Acute Care, Home Care, Behavioral Health, Skilled Nursing, Rehab, OP Diagnostic, Infusion Therapy, Radiation Oncology, and Physicians Offices (CMG).

Responsible for the coding accuracy and timeliness of the coding to meet regulatory and organizational requirements. The coding services are crucial to the cash flow of Covenant and have a direct impact on Covenant’s financial performance.

Responsibilities

• Directs a centralized medical coding operation to service the various business entities of Covenant Health, which includes the oversight, planning, and maintenance of daily activities and special projects as necessary to achieve and maintain business objectives. Business entities include companies directly under the Covenant Health umbrella, but might also include physician offices not directly owned, operated, or managed by Covenant Health.
• Responsible for team building and bringing together the coding staff from existing and new Covenant facilities into a central organizational structure and work group.
• Develops departmental policies and procedures, objectives, quality assurance programs and safety standards.
• Oversees the planning direction and supervision of all coding activities.
• Monitors the various reports to assure staff work to meet goals set relative to Days in Accounts Receivable, Unbilled Accounts and accounts with billing errors.
• Annual operating and capital budgeting.
• Monitors for changes in Coding laws and regulations, and assures that any necessary revisions are made to the policies and procedures in a timely manner.
• Oversees the development and implementation of the continuing education programs for the coding and transcription staffs.
• Works closely with KBOS, RAC and CDI personnel to assure that close linkages is maintained with special reference to billing and collection issues. Works on identified issues relative to denials of payment, as it relates to coding.
• Other duties as assigned.

Qualifications

Minimum Education:

None specified; however, must be sufficient to meet the standards for achievement of the below indicated license and/or certification as required by the issuing authority.

Minimum Experience:

Three (3) years supervisory experience in related health field required, acute care experience preferred. Familiarity with the Joint Commission, state and financial regulatory approach mandatory, as well as hospital finance, needed. Requires five (5) or more years of medical records experience in a supervisory role.

Licensure Requirement:

Certification as RHIA or RHIT required. ICD-10 training preferred.