Texas Tech University Health Sciences Center El Paso

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Unit Manager - Coding & Billing Division

at Texas Tech University Health Sciences Center El Paso

Posted: 4/11/2019
Job Status: Full Time
Job Reference #: 426956
Keywords: operations

Job Description

Extended Job Title
Unit Manager - Coding & Billing Division

Org Level 1
Texas Tech Unv Hlth Sci Ctr El Paso

Position Description
Manages a unit within a department. Plans, organizes and develops goals and procedures for the unit. Represents the unit to administrators, outside agencies and others on relevant matters. Supervises subordinate staff.
 

Requisition ID
15850BR

Travel Required
Up to 25%

Major/Essential Functions
1.   Responsible for the day-to-day overall operations of the Coding and Billing Division.  Ensures the division is running smoothly and proficiently.  Develops and implements processes and procedures for the operation of the practice.
2.   Selects and utilizes proper E/M level of service and procedure CPT codes for physician fees resulting in appropriate reimbursement.   Validates assigned evaluation and management codes based on health record documentation using the CMS 1995 E/M Documentation Guidelines.   Applies the official CPT and ICD-9 CM coding guidelines in accordance with payer standards.   Applies CMS teaching physician documentation guidelines contained in the CMS Internet Only Manual 100-04, Chapter 12, Section 100.  Applies to teaching physician documentation guidelines contained in the Texas Medicaid Procedure manual. 
3.  On a daily basis must access http://www.cms.hhs.gov/Center for Medicaid and Medical Services.   Reads and reviews important information to discuss and present to the department compliance officer and coding staff.  Implements new guidelines or revisions.   
4.  On a periodic basis accesses AHIMA/AAPC website for educational purposes and to use AHIMA/AAPC forum to address or discuss coding issues.
5.  Educates physicians, trains staff and enforces documentation guidelines and proper usage of CPT codes for billable services.  
6.  Performs audit on 10 random charts per physician per quarter.   
7.  Develops and recommends systems to capture professional fees and proper codes for reimbursement that can result in increased collection rates and a reduction in the number of claim denials and rejections.
8.  Must be able to read emergency medicine physician records and abstract codes 90% of the time.   CPT codes must be assigned with 90% accuracy.   
9.  Must be able to communicate with University Medical Center Patient Financial Services in a such a fashion that over 95% can be billed from data that is supplied.
10.  Coding:  Responsible for the supervision of two full-time Lead Coding and Reimbursement Specialist and one recurrent staff employee - Sr. Coding & Reimbursement Specialist.  Meets weekly, or on an as needed basis with coding and billing staff.
11.  Keeps track of approved coding reference material subscriptions for coding division.  
12.  Keeps informed on Medicare Fraud and Abuse Compliance issues by attending seminars and in-services.  Travels in/out of state to attend Emergency Medicine specialty trainings on coding and billing.
13. In conjunction with the department compliance officer, performs orientation to new residents, faculty and coders in the department of Emergency Medicine.  Annual refresher in-service is also done for existing faculty and non-coding departmental employees.
14.  Revises the charge description master update as required by the Texas Tech MPIP Business office. 
15.  Develops and maintains coder procedure outline for Emergency Medicine Department.  
16.  Billing:  responsible for the supervision of the Sr. Specialist - Denials & Appeals.    
17.  Responsible for ensuring various aspects of maintenance and research of denial/appeals with Sr. Specialist.
18.  Supervises Sr. Specialist for data entry.
19.  Responsible for ensuring all faculty that see patients are enrolled through the TT MPIP Business Office.
20.  On Medicaid retrospective charges, reviews charts tht are sent from UMC HIM.
21.  Supervises and assists in the researching of discrepancies in patient accounts.
22.  Responsible for daily and monthly billing reports.
23.  Other duties as assigned. 
 

Grant Funded?
No

Minimum Hire Rate
4000

Pay Basis
Monthly

Schedule Details
some weekends

Work Location
El Paso

Preferred Qualifications
POSITION SPECIFIC QUALIFICATIONS :  
Experience in managing all phases of medical billing including patient registration, charge and receipt entry, and insurance follow up; ensures office communication and education of billing and coding staff; improves charge capture and accuracy of data entry; prepares monthly reports and data analysis.  Must have knowledge and experience in using Business Office Patient Accounting computer system.  Develops and implements processes and procedures for the operation of Coding/Billing Division.  Certified coder.  Ability to read Emergency Medicine physician records and abstract codes over 90% of the time.  Correct codes imply both technical accuracy and compliance with all application federal documentation and teaching physician guidelines.  Ability to communicate with MPIP Billing department in a fashion such that > 95% of coding can be billed from data supplies.  Ability to meet with physicians individually and in small groups to review records and explain coding areas.  Protects data integrity and validity using software or hardware technology.  Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.  Assures all coding and billing reports are completed in an accurate and timely manner.  Knowledge of the CPT, ICD-10 and HCPCS nomenclature, coding rules and guidelines; knowledge of coding software applications.  Advanced understanding of medical terminology,body systems/anatomy and physiology and concepts of disease regulations.  Dependable in both production and attendance.    
Certification:  current certification through the American Health Information Management Association (AHIMA) in the following areas:  Certified Coding Specialist-Physician based (CCS-P); Certified Coding Specialist (CCS); Certified in Healthcare Privacy (CHP); Registered Health Information Administrator (RHIA); Registered Health Information Technician (RHIT); Certified Coding Associate OR current certification through the American Academy of Professional Coders (AAPC) in the following areas: Certified Professor Coder (CPC);  Certified Professional Coder- Hospital (CPH-H).   Supervisory experience.  Demonstrates and applies knowledge in TTUHSC policies and procedures of supervisory information.  Abides by the TTUHSC guidelines in the evaluation process.  Possesses good communication and supervisory skills.   Excellent oral and written communication skills.  Ability to write  clear, concise reports, and business correspondence.  Ability to read, analyze, and interpret professional journals, technical procedures, or governmental regulations.  Ability to write reports, business correspondence, and procedure manuals.  Ability to effectively present information and respond to questions from groups of managers , clients, customers and the general public.  Strong problem-solving skills, self-starter, ability to function with little or no supervision; ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists; ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form.   MATHEMATICAL SKILLS:  Ability to calculate figures and amounts such as discounts and percentages.  COMPUTER SKILLS:  To perform job successfully, an individual should have knowledge of database, spreadsheet software and word processing. 

PREFERRED:
Knowledge and experienced in the specialty of Emergency Medicine physician based coding, GE Centricity, Cerner, and Envision.  Intermediate or advanced experience and knowledge in Microsoft Office (Word, Excel, Outlook, PowerPoint, Access)

Campus
HSC - El Paso

Department
Emergency Medicine Elp Genl

Required Attachments
Cover Letter, Professional License or Certification, Resume / CV, Transcript

Job Type
Full Time

Pay Statement
Compensation is commensurate upon the qualifications of the individual selected and budgetary guidelines of the hiring department, as well as, the institutional pay plan. For additional information, please reference the institutional pay plan on the Human Resources webpage.

Job Group
Other Administrative

Shift
Day

EEO Statement
As an EEO/AA employer, the Texas Tech University System and its components will not discriminate in our employment practices based on an applicant’s race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, genetic information or status as a protected veteran.

Required Qualifications
Bachelor's degree plus three years supervisory experience; or a combination of education and/or supervisory experience to equal seven years.

Does this position work in a research laboratory?
No

Application Instructions

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