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Washington University in St. Louis · 3 weeks ago

Manager, Coding Compliance (Hybrid) - Pediatrics

St Louis, MO

Full-time

Hybrid

Senior Level

$68K/yr - $106K/yr

5+ years exp

Washington University in St. Louis is seeking a progressive and skilled Manager of Coding and Compliance for their Department of Pediatrics. The role involves overseeing the billing cycle and coding function, ensuring accuracy and compliance while maximizing revenue for a complex department.

E-LearningEBooksEducationHigher Education

Responsibilities

Supervise Coding Coordinators to assure hospital based services captured timely and to maximize revenue

Directly interact and communicate with faculty on coding, charge capture, compliance and other billing related issues

Perform compliance related duties such as review of medical documentation, completion of physician audits and OPBC audits

Develop educational material and conducts regular meetings with faculty to determine methods of improving coding and documentation

Assure staff attends scheduled training/in-services

Keeps abreast of procedures and changes affecting Medicare, Medicaid, HMO, PPO and related health care operations

Communicate policies and procedures to staff on billing issues to promote efficient flow of billing process and maximum reimbursement, aligned with compliance

Monitor weekly charges and work files

Assure weekly completion of hospital missing charge lists and report physician in noncompliance of divisional/departmental missing operative note policy

Assure OPBC and Departmental compliance guidelines applied to billed services

Serve as compliance liaison to WU Office of Physician Billing Compliance

Qualification

Coding ComplianceClinical DocumentationSupervisory ManagementEpic EMRHealthcare RegulationsTrend AnalysisTrend ReportingOrganizingAccountingCommunication

Required

Bachelor's degree or combination of education and/or experience may substitute for minimum education

Supervisory (5 Years)

Demonstrated excellence in the areas of ensuring coders are coding with accuracy, aligned with regulatory compliance rules, and supporting timeline reimbursement

Deep clinical experience, preferably as a nurse or other clinical staff member

Working knowledge of clinical workflows and the Epic EMR

Ability to oversee 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

Ability to 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

Preferred

AAPC (American Academy of Professional Coders)

CPC (Certified Professional Coder)

CCC (Certified Cardiology Coder)

RHIT (Registered Health Information Technician) from AHIMA

Certified Documentation Expert Outpatient (CDEO) - American Academy of Professional Coders (AAPC)

Ability to ask questions about conditions/diseases including understanding signs of deterioration and the risks of morbidity

Skills: Accounting, Code Compliance, Organizing, Supervisory Management, Trend Analysis, Trend Reporting

Benefits

Up to 22 days of vacation, 10 recognized holidays, and sick time.

Competitive health insurance packages with priority appointments and lower copays/coinsurance.

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%.

Wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program (EAP), financial resources, access to dietitians, and more!

We offer 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? We’ve 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.