Patient Financial Services Manager at St Francis House NWA Inc

Little Rock, Arkansas, United States -

Full Time

Start Date

Immediate

Expiry Date

06 Mar, 26

Salary

0.0

Posted On

06 Dec, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

ICD-10 Coding, Medical Coding, Training Development, Team Management, Quality Control, Coding Audits, EHR Systems, Attention to Detail, Interpersonal Skills, Bilingual Spanish/English

Industry

Description

Community Clinic is a patient-directed Community Health Center which provides affordable primary health care and supportive services to our neighbors in Northwest Arkansas. Community Health Centers, also known as Federally Qualified Health Centers, is a Federal designation whereby community health needs are identified and are responded to appropriately. We provide health care using a Patient-Centered Medical Home (PCMH) approach: the needs of the patient come first. Community Clinic recognizes that every employee plays a vital role. We care. You belong. Community Clinic is seeking an experienced Medical Coding Manager to join our Patient Financial Services team. This role is responsible for the development and execution of provider coding education and proper documentation according to guidelines to ensure coding compliance. The Coding Manager oversees all coding operations in a Federally Qualified Health Center (FQHC) clinic environment. In this leadership role, you will ensure the accurate and timely coding of clinical documentation and maintain strict compliance with coding guidelines and healthcare regulations. Working closely with a team of medical coders, providers, and clinic administrators, you will implement quality control processes to uphold coding accuracy, optimize reimbursement, and support the clinic’s reporting requirements. **THIS POSITION IS REMOTE ONLY TO ARKANSAS, OKLAHOMA, AND MISSOURI RESIDENTS** **ON-SITE OPTION IN SPRINGDALE, AR** Essential job functions * Serve as ICD-10 Subject Matter Expert (SME), providing on-going ICD-10 training as it relates to clinical decision making. * Develop and conduct group, online, and/or on-the-job training that provides guidance for new and existing providers and staff * Stay up-to-date with the latest coding guidelines, payer policies, and healthcare regulations (e.g., CMS updates, annual ICD-10/CPT changes). * Manage and supervise the coding team, providing guidance, support, and training as needed. * Assign workloads and oversee daily coding operations to ensure all patient encounters are coded promptly and accurately for billing. * Conduct regular team meetings and one-on-one check-ins to monitor performance and address any issues. * Review and analyze clinical documentation and medical records in eClinicalWorks (eCW) to ensure accurate and appropriate assignment of ICD-10-CM, CPT, and HCPCS codes. Verify that coding meets official guidelines and payer rules, including FQHC-specific billing requirements, to optimize reimbursements and avoid errors. Identify and address any coding discrepancies or compliance issues proactively. * Conduct regular coding audits (e.g., monthly chart audits) to verify coding accuracy, completeness, and compliance with regulations. * Develop audit protocols to ensure optimal coding for correct billing and identify areas for improvement. * Analyze audit findings and provide feedback to coders and providers, implementing corrective action plans or additional training where necessary. * Collaborate with the billing and revenue cycle management departments to streamline the billing process. * Assist in reviewing claim denials or rejections related to coding and provide expertise to correct and resubmit claims as needed. * Participate in meetings with finance or operations staff to discuss coding’s impact on reimbursements, and propose solutions to improve billing outcomes and maximize FQHC revenue while remaining compliant. * Stay abreast of current coding trends and provide official communication of diagnosis/CPT codes or other relevant information to providers/staff/management in writing/email. * Approve and initiate additions or changes related to diagnosis, CPT codes, or modifiers prior to updates taking place within the electronic health record system. Coordinate with IT on this effort so providers may access and select updated coding options in eCW. * Generate E&M code utilization reports from eCW to monitor provider coding patterns and conduct checks of documentation for providers whose E&M patterns deviate from the norm or are lagging behind completion. * Monitor and document timelines related to individual ICD-10 and coding education as it takes place. Measures ongoing change management for specific provider performance improvement as present in the electronic health record. * Assist with day-to-day coding duties as needed, including but not limited to reviewing provider documentation to ensure assignment and sequencing of procedural and diagnostic coding to ensure capture of accurate services and timely submission of claims. * Perform annual random provider E&M chart documentation reviews for all providers to ensure accurate selection of evaluation and management and other procedure codes (based on diagnosis) per Medicare, Medicaid and other Commercial payer requirements. * Administer knowledge checks and audits to ensure coding staff is appropriately trained and has basic coding/modifiers and skill sets necessary to be successful and support compliant processing. * Perform research and provide guidance to decrease coding based claims denials. * Review and advise on records documentation associated with formal audit requests prior to payer imposed deadline for response and develops provider education based upon these reviews. * Adheres to applicable regulatory guidelines and laws, including but not limited to HIPAA/HITECH, HRSA, NCQA PCMH and OSHA. Knowledge and critical skills * Proficient knowledge of Microsoft Office Software including Excel, Word and PowerPoint. * Proficiency with electronic health record (EHR) systems and coding software. * Experience with eClinicalWorks (eCW) is highly valued. * Experience with 3M coding software is highly valued. * Attention to detail and high level of organization * Ability to work and function independently and within a team. * Strong interpersonal skills and the ability to work effectively with people of all backgrounds. * Engages in professional development activities, such as trainings and CEUs. * Bilingual Spanish/English preferred. Qualifications * High School diploma or equivalent required. Associates degree in related field preferred * One of the following certifications is required: * Certified Professional Coder (CPC), or * Certified Coding Specialist Physician Based (CCS-P) * Obtain Community Health Coding & Billing Specialist within 12 months of hire or eligibility. * Minimum 5 years of medical coding experience in a clinical or ambulatory care setting required, with preferred 2 years in supervisory or lead coder role. * Federally Qualified Health Center (FQHC) experience a plus Why Join Community Clinic? * Be a part of a mission-driven organization committed to providing access to health-care to everyone in your community! * Excellent Benefits Package including: * Health, Vision, Dental and Life Insurance * 403(b) Retirement plan (automatic employer contribution of 5% per paycheck!) * Paid Time Off and 10 Annual Paid Holidays * Employee Discounts for Care Monday - Friday 8:00 AM-5:00 PM 40 Hours

Responsibilities

The Patient Financial Services Manager is responsible for overseeing coding operations, ensuring compliance with coding guidelines, and providing education to staff. This role involves managing a team of coders and collaborating with various departments to optimize reimbursement and maintain coding accuracy.