Description

Core Clinical Partners stands at the forefront of Emergency and Hospital Medicine, delivering unparalleled services through a model that emphasizes patient-centric care and operational excellence. Our corporate values – Genuine, Accountable, Dynamic, Respectful, and Fun – are the pillars that uphold our commitment to revolutionize healthcare delivery. 

The Hospital Medicine Coding Manager will collaborate with coders, providers, compliance, and revenue cycle team members on appropriate medical record documentation to assure accurate reflection of the level of patient care and acuity in support of optimum coding and reimbursement.

Essential Duties: 

• Routinely audit Medical Records for inconsistent coding practices and offer remediating solutions/education.
• Review and analyze billing data to identify documentation outliers on facility and clinician statistical levels.
• Evaluate current coding and documentation processes for continuous improvement opportunities.
• Perform ongoing outreach/education for new and existing coders on Hospital Medicine coding and documentation requirements using a variety of formats. 
• Advise and educate internal operations teams on documentation requirements by participating in Monthly Facility/Team Meeting group sessions. 
• Educate and counsel clinicians on appropriate use of respective facilities electronic medical record system.
• Monthly Facility analysis and trending to identify documentation and RVU outliers at the facility or provider level
• Action Plan development and outreach prioritization. 
• Outlier provider/facility escalation using established policies and processes.
• Participate in provider Electronic Medical Record (“EMR”) training and provide feedback/clarification on documentation and coding workflow concepts.
• Participate in company-wide initiatives related to clinical documentation improvement.
• Stay abreast of all federal, state, and payer guidelines and communicates to the Revenue Cycle team and other stakeholders as needed.
• Performs other related duties as assigned.

Requirements

• Strong organizational skills with the ability to multi-task in a fast-paced environment. 
• Ability to adapt, modify and prioritize while adhering to strict deadlines and a willingness to shift priorities to meet the needs of the organization. 
• Knowledge and understanding of medical coding and billing systems and regulatory requirements. Knowledge of legal, regulatory and policy compliance issues related to medical coding and billing procedures and documentation.
• Excellent communication and interpersonal skills and demonstrated ability to interact with a variety of team members.
• Self-motivated with the ability to identify opportunities for improvement and demonstrate the initiative to resolve issues in support of improvement efforts. 
• Strong analytical skills and the ability to work independently to analyze and solve problems. 
• Adept at learning proprietary software applications.
• Collaborate with professionals internal and external to the company and across geographic locations 
• Exhibit growth mindset and team-orientated behaviors 
• Navigate competing priorities and effectively work in a fast-paced environment

Education: 

• Preferred: RHIA, CDI, CPC, CCS, CCS-P
• Bachelor’s degree or equivalent is required

Experience: 

• 3-5 years’ experience in Hospital or Physician practice environment desired.
• Experience with Evaluation & Management coding; hospital medicine background preferred.
• EHR/EMR (Electronic Health Record/Electronic Medical Record) experience required.
• Chart Auditing/Optimization experience is a must

Core Clinical Management, LLC is an equal opportunity employer and complies with ADA regulations as applicable. 

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.