Contract IP and OP Coder
COMPETITIVE EDGE for Healthcare, LLC

Introduction:

Please contact me at your earliest convenience. I have a client who needs independent coding support on an per diem basis.

Job Description:

Preferably credentialed through AHIMA. Prefer 5 years experience. Reference check will be completed. Thank you for your prompt response.

Compensation/Benefits:

Let's talk!

Instructions for Resume Submission:

Email resume to comp.edge@hotmail.com as a WORD attachment. Thank you.

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MSHA Coding Manager
Mountain States Health Alliance

Introduction:

Mountain States Health Alliance in a 13 facility hospital system located throughout Northeast Tennessee and Southwest Virginia. In addition to our hospitals, MSHA's integrated healthcare delivery system includes 21 primary/preventive care centers and numerous outpatient care sites, including First Assist Urgent Care, MedWorks, Same Day Surgery, and Rehab Plus. Whether you are looking for a small community setting or a larger urban environment, MSHA has opportunities for you.

Job Description:

The MSHA Coding Manager has overall responsibility for patient Code Assignment and Chart Abstraction across the Mountain States Health Alliance system.

• As the coding and data quality expert, the incumbent is accountable for the accuracy of ICD-9-CM and CPT Codes and the appropriateness of DRG, APC, and ASC Group designations, enterprise-wide.

• The incumbent is the data owner and serves as the internal expert for data retrieval and aggregate reporting of current and historical coding statistics and trends.

• The person in this position develops and conducts ongoing coding and data quality education and training for Coding/Abstracting staff, as well as sessions designed for clinical and financial personnel throughout the organization, including Medical Staff.

• The incumbent serves as the resource to the organization for updates on Legislative and Third Party Payor changes related to coding and reimbursement.

• The person in this position serves as the first line of defense for the integrity of MSHA coding practices. Development of enterprise-wide coding policies, procedures and guidelines, and maintenance of the Corporate Coding Compliance Manual are included in the responsibilities of this position.

• The incumbent performs ongoing risk assessment for potential coding compliance problems, and creates and conducts internal coding audit programs and monitoring processes to insure appropriate practices.

• This individual participates in investigation efforts in conjunction with the Corporate Compliance Plan and Directives.
   

In addition to the above roles, this position participates as a member of the management team of Medical Records and has direct management responsibilities for Coding/Abstracting staff and day to day coding operations.

• This position is responsible for consistent coding/abstracting processes MSHA-wide.

• The incumbent monitors Accounts Pending status on an ongoing basis and coordinates with Financial Services to insure timely coding/billing standards, which are critical to the success and financial viability of the organization.

• The incumbent is responsible for creating and managing that portion of the operational budget related to Coding/Abstracting.

• This position serves as the departmental Systems Administrator for the 3M Coding Software products, and is the IS liaison for the SMS Medical Records Abstraction module.

• Initiative, perseverance, sound judgment, and a high aptitude for organization and attention to detail are required to carry out job duties. Proven project management skills are essential to effectively manage multiple, concurrent activities, with distinct and competing deadlines.

• Exceptional communication skills, both written and verbal, and excellent interpersonal, team-building skills required to successfully interact with all levels of personnel, including Senior Management and the Medical Staff, federal, state, local and regulatory agencies, legal counsel and consultants.

• The incumbent must be a strong leader, teacher, coach and role model for "good coder syndrome," with a strong work ethic and commitment to basic ethical and auditing principles.

Education Qualifications:

Qualifications include:

• A bachelor's degree in Health Information Management or related fields is preferred. RHIA, RHIT, or CCS credentials are required, along with specialized education and strong experience in ICD-9-CM and CPT-4 Coding. Five (5) years coding and/or auditing experience and/or three (3) years of management experience in Health Information Management preferred. Knowledge of principles of Medicare reimbursement is required, and knowledge of Tenncare reimbursement desired. Experience with computerized data systems is required; specific knowledge and experiences related to 3M coding software products and the MSHA's hospital information system desired. Significant professional experiences working with clinical records, billing, clinical data integration and analysis are required.

Compensation/Benefits:

Competitive Pay and Great Benefits

Instructions for Resume Submission:

Visit our website to learn more: www.mshahr.com
or
BlevinsKR@msha.com

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Corporate Coding Manager
Mountain States Health Alliance

Introduction:

Mountain States Health Alliance in a 13 facility hospital system located throughout Northeast Tennessee and Southwest Virginia. In addition to our hospitals, MSHA's integrated healthcare delivery system includes 21 primary/preventive care centers and numerous outpatient care sites, including First Assist Urgent Care, MedWorks, Same Day Surgery, and Rehab Plus. Whether you are looking for a small community setting or a larger urban environment, MSHA has opportunities for you.

Job Description:

The Corporate Coding Manager has overall responsibility for coding, coding abstracting, claims edits, medical necessity, coding audits and appeals, and coding education for both the hospital and MSHA Physician offices.

Responsibilities:

• This position has responsibility to ensure consistent, ethical, and accurate coding practices are in place throughout MSHA.

• Oversight responsibility for the development of enterprise-wide coding policies, procedures and guidelines, and maintenance of the Corporate Coding Compliance Manual.

• This position is responsible for streamlining coding practices and collaborating to ensure efficiencies and positive outcomes are achieved both in the hospital and physician practices.

• Responsible for ensuring coding meets the expectation for successful concurrent documentation improvement (CDI) program.

• Oversight for ongoing auditing and education is also a responsibility of this position.

• This position is responsible for working with appropriate team members to ensure software is updated as needed for all facilities and proactively stays abreast and coordinates ICD, CPT and DRG updates.

In addition to the above roles, this position participates as a member of the management team of Medical Records and has direct management responsibilities for Coding/Abstracting staff and day to day coding operations. This position is responsible for consistent coding/abstracting processes MSHA-wide. The incumbent monitors Accounts Pending status on an ongoing basis and coordinates with Financial Services to insure timely coding/billing standards, which are critical to the success and financial viability of the organization. The incumbent is responsible for creating and managing that portion of the operational budget related to Coding/Abstracting. This position serves as the departmental Systems Administrator for the 3M Coding Software products, and is the IS liaison for the SMS Medical Records Abstraction module.

Initiative, perseverance, sound judgment, and a high aptitude for organization and attention to detail are required to carry out job duties. Proven project management skills are essential to effectively manage multiple, concurrent activities, with distinct and competing deadlines. Exceptional communication skills, both written and verbal, and excellent interpersonal, team-building skills required to successfully interact with all levels of personnel, including Senior Management and the Medical Staff, federal, state, local and regulatory agencies, legal counsel and consultants. The incumbent must be a strong leader, teacher, coach and role model for with a strong work ethic and commitment to basic ethical and auditing principles.

MSHA expects that every team member will role model Patient-Centered Care behaviors and be guided by MSHA’s Values and the Principles of Patient–Centered Care. Every member of MSHA’s leadership team is accountable for coaching and monitoring reporting team members to ensure that the standards and initiatives of Patient-Centered Care are a living reality in their work units / Departments.

It is vital that an individual in this position be capable of good verbal and written communication skills.

Education Qualifications:

Qualifications include:

• A bachelor degree in Health Information Management or related fields is required.

• In lieu of BS degree appropriate equivalent years of work experience in management position will be considered.

• Experience may be substituted for education: basic qualification requirement on a 2:1 basis (2 years of experience for each year of education required, but not attained).

• Credentialed Certified Coding is required and credentialed as a Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) is strongly preferred.

• Experience with hospital and physician office coding, and working knowledge of ICD-9-CM, CPT-4, modifiers, billing edits, medical necessity, and RAC and other external agency audits required.

• Effective and outgoing communication style and outcome-focused management style required.

• Expertise with 3M encoder, document imaging, SMS Invision, Paragon, Meditech, HMS, and Allscripts applications systems preferred.

• Ability to adapt and learn new applications required.

• Professional expertise to effectively work with coders, billers, case management, CFO’s, and physicians. Ability to analyze, trend and report on coding outcomes, denials, audits, documentation opportunities, etc.

• Experience may be substituted for education: basic qualification requirement on a 2:1 basis (2 years of experience for each year of education required, but not attained).

Compensation/Benefits:

Competitive Pay and Great Benefits

Instructions for Resume Submission:

Visit our website to learn more: www.mshahr.com
or
BlevinsKR@msha.com

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Coding Practice Manager
Mountain States Health Alliance

Introduction:

Mountain States Health Alliance in a 13 facility hospital system located throughout Northeast Tennessee and Southwest Virginia. In addition to our hospitals, MSHA's integrated healthcare delivery system includes 21 primary/preventive care centers and numerous outpatient care sites, including First Assist Urgent Care, MedWorks, Same Day Surgery, and Rehab Plus. Whether you are looking for a small community setting or a larger urban environment, MSHA has opportunities for you.

Job Description:

The Coding Practice Manager is responsible and accountable for validating coding to ensure accuracy resulting in the highest legitimate reimbursement possible, while carefully maintaining compliance with all Federal and State regulatory requirements as well as accrediting requirements. This person functions as the first-line defense and recognized expert for BRMMC in oversight of the technical complexities and regulatory implications of coding operations, a major point of exposure for physician practices under the Federal False Claims Act. Has responsibility for training team members in coding guidelines. Responsibility includes:

• designing and implementing an ongoing Education and Performance Improvement Process with controls and measurements that ensure correct processes are in place for correct coding (based on HCFA endorsed coding guidelines - AHA Coding Clinical and CPT Assistant) supported by medical record documentation.  The process must function effectively to avoid careless practices that may result in unsubstantiated higher reimbursement.

• This person has the responsibility for working as a liaison with physicians and other caregivers for documentation issues and as a liaison with the Corporate Compliance Department.

Education Qualifications:

• Requires a bachelor's degree in Health Information Management or related field. RHIA, RHIT , CCS or CPC credentials are required (or must be able to receive these credentials within 12 months of being employed)

• Must have specialized education and experience in ICD-9-CM and CPT4 coding. Significant professional experience working with clinical records and billing is required.

• Must have experience in clinical data integration and analysis.

• Experience with computerized data systems is required.

• Thorough familiarity with relevant laws and accrediting requirements is required.

• Must have knowledge to set up user-friendly verification, auditing and reporting systems.

• To function effectively, certain personality traits are important as the resume.

• The candidate must possess a strong work ethic, a commitment to basic ethical and auditing principles, ability to coach and role-model "Good Coder Syndrome".

• Must be able to relate cooperatively and constructively with physicians and healthcare team members from other areas of the health care system.

Compensation/Benefits:

Mountain States Health Alliance offers competitive pay and great benefits.

Instructions for Resume Submission:

Visit our website to learn more: www.mshahr.com
or
BlevinsKR@msha.com

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