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Coding Manager

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Job ID 22REQ-04207 Location Remote Company Name Xtend Healthcare, LLC

***Xtend offers competitive benefits including Medical/Dental/Vision, Generous Paid Time Off/Paid Holidays/Tuition Reimbursement/401k plan plus Employer Match/Professional Development***

Xtend Healthcare, a Navient company, is nationally recognized as the industry-leading provider of comprehensive revenue cycle solutions to hospitals and health systems. Sustaining healthcare revenue cycle improvement is our exclusive focus with experience in all 50 states and more than 30 years of dedicated health revenue cycle experience. We are committed to delivering solutions built around the broad revenue cycle needs of our clients.

Xtend Healthcare focuses on both clinical and financial interoperability to maximize collection of net revenue. Xtend Healthcare provides an array of solutions for our customers including full and partial revenue cycle outsourcing, third-party insurance follow-up, self-pay, coding, CDI, and consulting services.

THIS IS A REMOTE (WORK FROM HOME) POSITION.

The Coding Manager is responsible for leading two or more teams of coders and auditors for fifteen to thirty projects that provides hospital and physician (provider) coding, auditing and medical records documentation improvement services.Must have the ability to accurately audit and code (ICD-10-CM, ICD-10-PCS, CPT, HCPCS, Level I & II modifiers) all of the following service types: facility inpatient, emergency room, outpatient surgery, observation, ancillary, recurring therapy, clinic, professional, and billing/coding edit resolution.Will be working with multiple facility specific, state billing and coding guidelines as well as various Medicare Administrative Contractors nation-wide.

  • Complete working knowledge and understanding of the full revenue cycle.
  • Responsible for analyzing, reviewing, and resolving coding and documentation issues that are related to reimbursement, compliance and revenue enhancement for each client. 
  • Responsible for reporting to the Director the coding statuses per client and type of service daily.
  • Directs the management of all coding functions for each client including:  Work volume, daily DNFB management, error resolution and feedback to client. 
  • Responsible for reporting to AVP for each of the clients and each type of service the productivity and accuracy of coding staff on a monthly basis.  Prepares monthly client reports. 
  • Acts as a Client Liaison to each project for questions, meetings, etc.  Significant customer interface responsibilities with hospital employees, physicians, mid-level providers, nursing, clinical, IS, patient financial services and registration.
  • Responsible for employee time management, maintaining employee daily time sheets per pay period per month, time allocations per project, reviewing and approving PTO requests; making sure the clients are covered during PTO dates.
  • Responsible for team member annual evaluations and career tracking.
  • Works hand in hand with the Manager of Coding Auditing regarding educational needs for team members.  Recommend improvements and corrections as identified. 
  • Holds team meetings and attends all departmental management meetings.  Prepares reports for meeting presentations.
  • Performs special projects for AVP.  
  • Reviews departmental incentives based upon review of quarterly team reports. 
  • Must possess a working knowledge of Medicare and Local Medical Review Policy Guidelines.
  • Ability to function independently and as a team player in a fast-paced environment required.
  • Knowledge of inpatient and DRG coding.
  • Knowledge of computing observation hours.
  • Knowledge of coding infusions and injections. 
  • Knowledge of surgical coding.
  • Knowledge of Evaluation and Management coding.
  • Must be able to maintain the company accuracy rating of 95%. 
  • Must meet set weekly quota for productivity. 
  • Knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM); Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT).
  • Knowledge of reimbursement systems, including Prospective Payment System (PPS); Ambulatory Payment Classifications (APCs); and Resource-Based Relative Value Scale (RBRVS).
  • Practical knowledge and understanding of industry nomenclature; medical and procedural terminology; anatomy and physiology; pharmacology; and disease processes.
  • Practical knowledge of medical specialties; medical diagnostic and therapeutic procedures; ancillary services (includes, but is not limited to, Laboratory, Occupational Therapy, Physical Therapy, and Radiology).
  • Make well-informed, effective, and timely decisions, even when data are limited or solutions produce unpleasant consequences; perceives the impact and implications of decisions.
  • Utilize medical computer software programs to abstract, analyze, and/or evaluate clinical documentation and enter/edit diagnosis, procedure codes and modifiers.
  • Clearly express information (for example, ideas or facts) to individuals or groups effectively, taking into account the audience and nature of the information.
  • Display courtesy, empathy, and tact, developing and maintaining effective relationships with others; effectively work with individuals who are difficult, hostile, or distressed to resolve differences; and be able to relate well to people from varied backgrounds and in different situations.
  • Work with internal and external customers to assess their needs, provide information or assistance, resolve their problems, or satisfy their expectations.
  • Contribute to maintaining the integrity of the organization; display high standards of ethical conduct and understand the impact of violating these standards on an organization, self, and others.
  • Be open to change and new information; adapt behavior or work methods in response to new information, changing conditions, or unexpected obstacles; effectively deals with uncertainty.
  • A high level of effort and commitment towards performing the work, using efficient learning techniques to acquire and apply new knowledge and skills; uses training, feedback, or other opportunities for self-learning and development.
  • Understand and interpret written material, including technical material, rules, regulations, instructions, reports, charts, graphs, or tables; applies what is learned from written material to specific situations. Working Excel knowledge. 
  • Attention to detail and completeness with a thorough understanding of government rules and regulations, medical coding and reimbursement guidelines, and potential areas of risk for fraud.

JOB SUMMARY:

1.  Personnel Management                                                                                                        

            a.  Orientation and training coders

            b.  Leading coders and managers on completion of daily work tasks

c.  Evaluating performance and carrying out improvement activities

2.  Training                                                                                                                               

            a.  The Manager must stay up-to-date on quarterly CMS, AHIMA and AAPC

                       coding guidelines on added, deleted and/or revised ICD-10-CM

                       and PCS codes, as well as CPT-4 and HCPCS Level II codes

                       and national coding clinics and edits (NCCI, OCE, MUE, etc.)

            b.  Manager acts as the “train the trainer” resource for all coding quality

                       updates, which means training the managers who trains

                       the coders in their area of specialty

            c.  Manager also trains the coders themselves on annual revisions.

            d.  Manager may travel to be on-site at a client location to provide both

                       coder and/or physician (provider) training

3.  Problem solving when client system, Xtend system, and/or client demands

     present immediate needs                                                                                                     

a. Client’s system may be down and coder cannot connect or access

     work queue – must resolve problem quickly or formulate strategy

     for work completion to meet client’s daily production goals.

Xtend’s VPN or system may be down requiring the determination of a

     solution for the coder to complete his or her daily work

Clients may telephone on a daily basis requesting addition coding

     assistance and/or audits

4.  Record Keeping                                                                                                                   

            a. Completion of Daily client and coder statistics

            b. Completion of Time Allocation reports daily

5.  Client and Xtend Project Interaction to Implement and Manage Coding Projects                      

Manager works with the Director and formulates and discusses coding / auditing needs to send

proposal from Xtend

            b.  Reviews client technology and processes to implement coding,

                       auditing and medical documentation services by Xtend coders.

                       This requires an understanding of the client’s HIM coding system

                       and their patient accounting system; and the expertise to connect

                       through Xtend’s VPN for access and remote coding ability

Reports and discusses with clients monthly coding performance

MINIMUM REQUIREMENTS:

  • Bachelor’s Degree (Additional equivalent experience above the required minimum may substitute for required level of education)
  • Ten or more years with coding and/or billing in health care revenue cycle experience.  This should include hospital and/or physician practice. (Additional equivalent education above the required minimum may substitute for the required level of experience)
  • Coding Certifications: The following are recognized professional certifications: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Coding Associate (CCA); Certified Professional Coder (CPC); Certified Outpatient Coder (COC); Certified Inpatient Coder (CIC); Certified Coding Specialist (CCS); or Certified Coding Specialist – Physician (CCS-P); Certified Professional Medical Auditor (CPMA). Coding Auditor III team members are required to possess at least one of the above professional services coding certifications.
  • AHIMA Approved ICD-10 CM and PCS Trainer.
  • Continuing Education Requirements: Medical coders shall maintain the required continuing education hours in order to maintain current and proper national certification(s) requirements for this position.
  • Coding Test. Pass a pre-employment coding test that is provided, developed and administered by candidate management instructions, with a score of 80% or higher.

PREFERRED QUALIFICATIONS:

  • An understanding of healthcare billing practices and compliant claims preparation for both governmental and commercial payers.
  • Revenue Cycle Certifications:  The following are recognized professional certifications:  Certified Professional Account Representative (CPAR), Certified Revenue Cycle Representative (CRCR) or Certified Professional Biller (CPB).
  • Electronic health record (EHR) expertise, including knowledge of a variety of vendors.
  • Specialty Coding Certifications:  The following are recognized professional certifications:  Ambulatory Surgical Center (CASCC), Anesthesia and Pain Management (CANPC), Cardiology (CCC), Cardiovascular and Thoracic Surgery (CCVTC), Chiropractic (CCPC), Dermatology (CPCD), Emergency Department (CEDC), Evaluation and Management (CEMC), Family Practice (CFPC), Gastroenterology (CGIC), General Surgery (CGSC), Hematology and Oncology (CHONC), Internal Medicine (CIMC), Interventional Radiology and Cardiovascular (CIRRC), Obstetrics Gynecology (COBGC), Orthopaedic Surgery (COSC), Otolaryngology (CENTC), Pediatrics (CPEDC), Plastics and Reconstructive Surgery (CPRC), Rheumatology (CRHC), Surgical Foot & Ankle (CSFAC), and Urology (CUC).


All offers of employment are contingent on standard background checks. Navient and certain of its affiliated companies are federal, state and/or local government contractors. Should this position support a Federal Government contract, now or in the future, the successful candidate will be subject to a background check conducted by the U.S. Government to determine eligibility and suitability for federal contract employment for public trust or sensitive positions. Positions that support state and/or local contracts also may require additional background checks to determine eligibility and suitability.

EOE Race/Ethnicity/Sex/Disability/Protected Vet/Sexual Orientation/Gender Identity. Navient Corporation and its subsidiaries are not sponsored by or agencies of the United States of America.

Navient is a drug free workplace.

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Benefits

  • Comprehensive Health, Dental and Vision Plans

  • 401K with Company Match (after 6 months)

  • Tuition Reimbursement

  • Generous PTO Starting at 15 Days and 8 Paid Holidays

  • Paid Parental Leave and Adoption Assistance

  • Employee Stock Purchase Plan

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