Manager, Coding Compliance (Hybrid) - Pediatrics

divh2Manager Of Coding And Compliance / h2pThe Department of Pediatrics is seeking a progressive and skilled Manager of Coding and Compliance. The Manager will oversee the billing cycle and coding function of a large, complex department of 15 clinical division with both inpatient and outpatient coding and coding review involved. Demonstrated excellence in the areas of ensuring coders are coding with accuracy, aligned with regulatory compliance rules, and supporting timeline reimbursement is required. This role serves as the subject matter expert for coding guidelines and must stay current about CMS changes and payor policies as well as any healthcare regulations that may impact coding, billing, and reimbursement. The Manager oversees day-to-day operations of charge capture activities assuring compliance and maximizing revenue and should have deep clinical experience, preferably as a nurse or other clinical staff member. They will manage the coding team that reviews and analyzes clinical documentation and medical records. The Manager should have working knowledge of clinical workflows and the Epic EMR. This leader is responsible for overseeing a team reviewing complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. This leader will also assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letters, and other resolution mechanisms designed to obtain maximum reimbursement in a compliant way. / ppPrimary Duties Responsibilities : / pulliSupervise Coding Coordinators to assure hospital based services captured timely and to maximize revenue. / liliDirectly interact and communicate with faculty on coding, charge capture, compliance and other billing related issues. / liliPerform compliance related duties such as review of medical documentation, completion of physician audits and OPBC audits. / liliDevelop educational material and conducts regular meetings with faculty to determine methods of improving coding and documentation. / liliAssure staff attends scheduled training / in-services. / liliKeeps abreast of procedures and changes affecting Medicare, Medicaid, HMO, PPO and related health care operations. / liliCommunicate policies and procedures to staff on billing issues to promote efficient flow of billing process and maximum reimbursement, aligned with compliance. / liliMonitor weekly charges and work files. / liliAssure weekly completion of hospital missing charge lists and report physician in noncompliance of divisional / departmental missing operative note policy. / liliAssure OPBC and Departmental compliance guidelines applied to billed services. / liliServe as compliance liaison to WU Office of Physician Billing Compliance. / li / ulpWorking Conditions : / pulliNormal office environment. / liliTypically sitting at a desk or table. / liliOffice equipment. / li / ulpRequired Qualifications : / pulliEducation : Bachelors degree or combination of education and / or experience may substitute for minimum education. / liliCertifications / Professional Licenses : No specific certification / professional license is required for this position. / liliWork Experience : Supervisory (5 Years) / liliSkills : Not Applicable / liliDrivers License : A drivers license is not required for this position. / li / ulpPreferred Qualifications : / pulliAAPC (American Academy of Professional Coders). / liliCPC (Certified Professional Coder). / liliCCC (Certified Cardiology Coder). / liliRHIT (Registered Health Information Technician) from AHIMA. / liliAbility to ask questions about conditions / diseases including understanding signs of deterioration and the risks of morbidity. / li / ulpGrade : C13 / ppSalary Range : $68,100.00 - $105,500.00 / Annually / ppFor frequently asked questions about the application process, please refer to our External Applicant FAQ. / ppIf you are unable to use our online application system and would like an accommodation, please email CandidateQuestions@wustl.edu or call the dedicated accommodation inquiry number at 314-935-1149 and leave a voicemail with the nature of your request. / ppAll qualified individuals must be able to perform the essential functions of the position satisfactorily and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions of their job, absent undue hardship. / ppAll external candidates receiving an offer for employment will be required to submit to pre-employment screening for this position. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure / certification verification, physical examination, certain vaccinations and / or governmental registry checks. All offers are contingent upon successful completion of required screening. / ppPersonal benefits include up to 22 days of vacation, 10 recognized holidays, and sick time. Competitive health insurance packages with priority appointments and lower copays / coinsurance are also provided. Take advantage of our free Metro transit U-Pass for eligible employees. WashU provides eligible employees with a defined contribution (403(b)) Retirement Savings Plan, which combines employee contributions and university contributions starting at 7%. / ppWellness benefits include wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program (EAP), financial resources, access to dietitians, and more! / ppFamily benefits include 4 weeks of caregiver leave to bond with your new child. Family care resources are also available for your continued childcare needs. Need adult care? Weve got you covered. WashU covers the cost of tuition for you and your family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years with us. / ppFor policies, detailed benefits, and eligibility, please visit : https : / / hr.wustl.edu / benefits / / ppWashington University in St. Louis is committed to the principles and practices of equal employment opportunity and especially encourages applications by those from underrepresented groups. It is the Universitys policy to provide equal opportunity and access to persons in all job titles without regard to race, ethnicity, color, national origin, age, religion, sex, sexual orientation, gender identity or expression, disability, protected veteran status, or genetic information. Washington University is dedicated to building a community of individuals who are committed to contributing to an inclusive environment fostering respect for all and welcoming individuals from diverse backgrounds, experiences and perspectives. Individuals with a commitment to these values are encouraged to apply. / p / div