System Manager of Coding

The System Manager of Coding is responsible for assisting other leaders and supervisors with planning, directing, organizing, monitoring and staffing the hospital and professional coding teams subject to policies, budgets, objectives and directives mandated by regulatory agencies, DNV, and the executive team. Supports Coding supervisors in maintaining team discipline for all elements of established standard processes (work management, tools, team briefings, metrics tracking, and prompt resolution of issues, problems, and opportunities).   Directs and coordinates all functions that relate to coding and applicable billing activities for Bozeman Health and all related entities. Researches, develops and facilitates education for all department functions regarding coding.   Works closely and collaboratively with all revenue cycle functions, interfacing with PFS, IT, compliance, finance, physicians and clinical departments.  This role is critical to the accurate development of claims, using a current working knowledge of organizational structure, coding principles, governmental regulations, protocols, and third party requirements regarding coding and coding compliance to ensure ethical, accurate, and complete coding, preventing and mitigating edits and denials.

Minimum Qualifications:

• Associate’s or Bachelor's degree in Health Information Management and corresponding certification (RHIT or RHIA); will consider Coding Certification (CCA, CPC, CCS/CCS-P) with coding leadership experience
• Three (3) years of experience in healthcare administration, revenue cycle, health information management, or coding
• Three (3) years supervisory or management experience
• Knowledge of diagnostic and procedural coding systems, electronic code processing
• Regulatory knowledge for PPS and CAH Hospital, Provider-Based, Free-Standing Clinic, and Swing Bed Coding
• Preferred: Master’s degree in healthcare administration or business administration or related field.
• Preferred: Prior coding management experience; Epic & 3M proficient

Essential Job Functions:

In addition to the essential functions of the job listed below, employees must have on-time completion of all required education as assigned per DNV requirements, Bozeman Health policy, and other registry requirements.

• Provides leadership to facility and professional coding operations to ensure the provision of comprehensive coding services in compliance with all regulatory agencies and organizational requirements, through continuous assessment, measurement, and improvement of departmental performance
• Ensure efficient and precise coding to support the accurate development and submission of claims for reimbursement, including timely filing requirements
• Monitor coding key performance indicators (KPIs), i.e. accounts receivable days, candidate for billing, coding edits and external errors, and denials
• Develop reports/dashboards to summarize coding trends or program deliverables to the applicable committees, work groups, and department leaders
• Analyze, track, and resolve payer edit and denial trends to mitigate underpayments and facilitate timely reimbursement
• Conduct research regarding coding edits and denials as directed, collaborating with revenue cycle teams on prevention and resolution
• Maintain knowledge of the CPT, ICD-10-CM, and HCPCS coding systems, as well as in depth-knowledge of healthcare reimbursement processes/systems to inform functional needs of the coding team and revenue cycle partners
• Collaborates with the system director to ensure a departmental approach to long-range strategic operational planning, care and service design and development of organizational policies, which reflect the mission of the organization, best practices, and ensure the provision of comprehensive departmental services in compliance with all regulatory agencies and healthcare system requirements
• Develops and monitors competency content/format and educational resources to ensure team alignment with current coding systems and guidelines
• Publishes educational material based on latest updates in workflows, regulations, industry guidelines, or clinician requested topics
• Establishes, develops, and oversees internal coding quality monitoring programs
• Demonstrates responsible management of all coding resources, including assessment of staffing models for efficient allocation of resources
• Demonstrates clinical/technical and managerial competency; ensures staff professional needs are met
• Leads, teaches, inspires, helps and consistently demonstrates hospital healthcare system standards

Knowledge, Skills and Abilities

• Strong leadership managerial skills; ability to plan, delegate, monitor and improve work performance
• Demonstrates sound judgement, patience, and maintains a professional demeanor at all times
• Ability to escalate issues to director and provide possible issue resolution
• Ability to work in a fast-paced environment
• Strong interpersonal, verbal, and written communication skills
• Creativity, problem analysis, and decision making
• Exercises tact, discretion, sensitivity, and maintains confidentiality

• Detail oriented, organizational skills, and the ability to prioritize
• Standard office equipment and computer applications; MS Office, EMR, internet applications etc.

Physical Requirements

• Lifting, Pushing, and Pulling: Lift 50 pounds of weight (pick up materials, move equipment, etc.) Carry equipment/supplies. Use upper body strength (repair and maintenance work, etc.)
• Extended Hours: The role may involve working for extended periods, requiring sitting, walking, or standing for eight or more hours daily.
• Flexible Schedule: The position may necessitate working beyond a standard 40-hour workweek, including weekends and after-hours shifts.
• On-Call Availability: On-call work may be required to respond to organizational and patient needs promptly.
• Effective Communication: Proficient in effective communication, both in person and through various technologies.
• Handling Challenging Situations: The role may involve dealing with upset individuals, requiring the ability to de-escalate situations and work effectively with frustrated patients or families.
• Repetitive Tasks: Ability to perform repetitive tasks as needed to fulfill job responsibilities.          

Exposures

Tasks Include Potential Exposure: Job tasks may involve exposure to:

• bloodborne pathogens, such as blood, bodily fluids, or tissues.
• radiation in settings where medical imaging procedures are performed.
• various chemicals and medications used in healthcare settings. Job tasks may involve handling cleaning products, solvents, paint, disinfectants, and other substances.
• infectious diseases due to contact with patients in areas that may have contagious illnesses.