MGR CLINICAL DOC/CODING QUAL at Premier Health

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Full Time

Start Date

Immediate

Expiry Date

04 Feb, 26

Salary

0.0

Posted On

06 Nov, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Clinical Documentation Improvement, Policy and Procedures, Billing Integrity, ICD-10 Implementation, Regulatory Initiatives, Coding Documentation Improvement, Reimbursement Management, Health Information Management, Financial Analysis, Customer Service, Oral Communication, Written Communication, Microsoft Word, Microsoft Excel, CPT Coding, HCPCS Coding

Industry

Hospitals and Health Care

Description

Summary of Position The Manager of Process Improvement and Compliance is responsible for leading and directing across Premier HealthNet, Premier Health Specialists and Upper Valley Professional Corp collectively know as The Network, by assisting in areas related to policy and procedures, clinical documentation improvement, and maintaining the integrity and accuracy of all aspects of billing. The candidate is responsible for reviewing, and communicating the outcomes related to all internal and external audits. The Manager of Process Improvement and Compliance will act as the Project Manager for the ICD-10 Implementation as well as playing a key role in implementing and participating in other regulatory initiatives. The Manager of Process Improvement and Compliance will lead and serve on various ad hoc PHP committees and will act as the subject matter expert representing The Network for PHP coding documentation improvement initiatives. The Manager of Process Improvement and Compliance will oversee the Coding Analyst and will report directly to the Director of AR Services. Nature and Scope The Manager of Process Improvement and Compliance is in charge of clinical documentation improvement and developing best practices for capturing the data required to ensure proper reimbursement for our Physician Practices. This position will be responsible for overseeing the research, training, and follow-up of reimbursement and revenue management, documentation, and health information management issues which affect the operations of The Network. The Manager of Process Improvement and Compliance will act as a physician liaison as applicable and oversee the Coding Analyst as it relates to physician and staff training with regards to documentation improvement. The candidate will provide professional consulting to physicians and corporate staff in areas of profitability analysis. The candidate will interact with physicians, practice managers, office staff, corporate staff, as well as hospital based and non-hospital based resources. Qualifications Education: Bachelors of Science Degree in Health Information Management required. Certification: RHIA Required. Experience: At least four (4) years experience with physician office coding. Demonstrated working knowledge of professional billing Experience with Epic EMR preferred Skills: The candidate must demonstrate successful presentation techniques and possess excellent organizational, customer service, and both oral and written communication skills. He/She should possess a strong knowledge base of ICD-9-CM, CPT and HCPCS coding, financial analysis techniques, costing, federal and state regulatory processes, insurance billing, third party payer requirements, outcome measurements, medical information management and practice patterns. He/She should also have advanced knowledge of Microsoft Word and Excel.

Responsibilities

The Manager of Process Improvement and Compliance leads clinical documentation improvement and ensures billing accuracy across The Network. They oversee audits, implement regulatory initiatives, and serve as a liaison for physician training.