Allegheny Health Network
Job Description :
Plans, directs, organizes, and controls the coding sections of multiple facilities to assure timely coding for billing and coding compliance.
- Plans, organizes, directs, and manages the activities, budget, and employees for multiple facilities. (30%)
- Assures timely and accurate coding / abstracting to comply with regulatory agencies and fiscal intermediaries and meets turnaround time of less than four (4) days. Assures validation process required by external agencies, e.g., PA Health Care Cost Containment Council. (25%)
- Assures that audited records are coded correctly, appealed if appropriate, follow-ups on process, and identifies education issues. Educates medical staff, residents, registration and medical record staff regarding coding compliance and clinical documentation. (25%)
- Administers the computer system, and coordinates database requests for reports. (10%)
- Designs, implements and maintains quality control measures, PI indicators, and productivity monitors. (5%)
- Performs all Human Resources functions for staff. Performs all steps necessary related to hiring, evaluation, coaching, promoting, disciplining and discharging employees by following established HR policies. (5%)
- Performs other duties as assigned.
- Associate’s Degree required. If no degree then five years’ experience in a medical record setting in addition to at least one of the following certifications must apply: Registered Health Information Technician (RHIT) or certification from a certifying body such as Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Evaluation and Management Coder (CEMC), etc.
- Five years’ experience in medical record setting.
- Three years coding, encoder, grouper, abstracting, registration and bill systems experience.
- Excellent computer skills.
- Must have a valid driver’s license and reliable transportation.
- Registered Health Information Technician (RHIT) or certification from a certifying body preferred (Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Evaluation and Management Coder (CEMC), etc.).
- Three years’ management experience.
- Experience in an academic medical center.
- Knowledge of JC, DOH, CMS and other regulatory standards.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
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