Management & Supervision
Clinic Billing Services
Full Time
8 Hour Shift
Rancho Mirage, CA 92270
Job #
  • Job Objective: A brief overview of the position.
    • Under minimal supervision is responsible for planning, organizing and managing the Coding and Charge Capture and review department to provide optimum coding in accordance with CMS and facility compliance guidelines, procedures, goals and standards; ove4rsees proper CPT and ICD 10 coding on a daily basis and services as a liaison between the Coders, Physician champions, physician liaisons, office manager and staff.
  • Reports to
    • Director, Clinic Billing
  • Supervises
    • Coding/ Charge Capture Supervisor; coders and charge capture staff 
  • Ages of Patients
    • None
  • Blood Borne Pathogens
    • Minimal/ No Potential
  • Qualifications
    • Education
      • Required: High School graduate or equivalent College level degree in related field
    • Licensure/Certification
      • Required: CCS or CPC
      • Preferred: RHIT, RHIA current certification
    • Experience
      • Required: three to five years of Coding Management experience working in a hospital based/ Medical Group setting or Large multispecialty group practice (50 or greater)
      • Preferred- five to seven years’ experience in a medical office/ hospital environment as noted above with responsibility for developing and maintaining an internal coding program included but not limited to coordination with local colleges and certification programs
  • Essential Responsibilities
    • Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
    • Ensures appropriate distribution of work based on productivity standards departmental policies and goals
    • Coordinates provider audits according to compliance program guidelines
    • Coordinates and conducts ongoing Quality coder audits per policy to ensure continued accuracy as outlined in the compliance policy
    • Monitor productivity of each member of the clinic coding/ charge capture/ review staff, providing them with consistent feedback on their successes and identifying any areas of needed improvement
    • Coordinates with the Director and Compliance Officer to update/ amend the Coding/ billing Compliance policy and program
    • Assist with recruitment and screening of potential applicants and participate in selection and hiring process
    • Coordinate with the Clinic Billing manager resolution of claim edits and creation of additional edits as indicated
    • Assist ion staff and provider training sessions
    • Complete staff evaluations with input supervisor and customers served
    • Maintain Kronos for all staff including timely intervention and coaching or counseling related to absence or tardies per EMC policy
    • Coordinates the update and distribution of new codes and deleted codes in a timely manner including any appropriate training related to the use of said codes
    • Monitor charges and encounters based on prior statistical data and investigate variances greater or less than 10 percent
    • Coordinates the activities of the Physician Liaisons based on specific clinic or provider needs
    • Conducts staff meetings to provide feedback on unit operations discuss problematic issues and introduce new procedures and/or regulations
    • Identify problems and recommend procedural changes when appropriate
    • Maintain current workflows for all areas
    • Interact with Clinic managers and CAO’s on coding issues or concerns including creation of any charge documents or revision thereof
    • Coordinate with Billing Manager and Director to monitor billing performance to ensure optimal reimbursement while adhering to regulations related to unbundling and other questionable practice
    • Provides reports and education related to unrealized revenue due to documentation issues
    • Attends meetings as deemed necessary to support the positions requirements including any CEU needs
    • Maintain current certifications as applicable and monitors staff relative to same
    • Complete and submit any expense reimbursement requests by the 10th of the following month
    • Perform other duties as needed