Outpatient Coding Manager

Introduction

Do you want to join an organization that invests in you as a Outpatient Coding Manager? At HCA Healthcare, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.

Benefits

• At HCA Healthcare, we want to ensure your needs are met. We offer eligible colleagues an attractive benefit package that includes medical, wellbeing, dental and vision benefits along with some unique benefits including:
• Medical, Dental, Vision, Life Insurance and Flexible Spending
• Paid Time Off (PTO) and Personal Leave
• 401K (100% annual match - 3% to 9% of pay based on years of service)
• Academic Assistance and Reimbursements for Tuition and Student Loans
• Employee Discounts including Tickets, Retail, Mental Health Apps, Education Apps, Identity Theft Protection etc.
• Home, Auto, and Pet Insurance
• Employee Stock Purchase Program (ESPP)
• Short Term & Long Term Disability coverage
• Adoption Assistance
• Legal Benefits and lots more!

Learn more about Employee Benefits

You contribute to our success. Every role has an impact on our patients' lives and you have the opportunity to make a difference. We are looking for a dedicated Outpatient Coding Manager like you to be a part of our team.

Job Summary and Qualifications

One of the nation's leading provider of healthcare services, HCA Healthcare is made up of locally managed facilities that include approximately 300 hospitals and freestanding surgery centers in 20 U.S. states and in the United Kingdom. HCA Healthcare employs approximately 300,000 people and approximately 4-5% of all inpatient care delivered in the country today is provided by HCA Healthcare facilities. HCA Healthcare is committed to the care and improvement of human life and strives to deliver high quality, cost effective healthcare in the communities we serve.

The Internal Audit Department provides an independent appraisal function to validate management control systems and to support corporate management in the effective discharge of their responsibilities and efforts to achieve the Company's overall mission. The Outpatient Services Coding and Billing Compliance Team test work is focused on ensuring claims are coded and billed in compliance with CMS regulations and HCA Healthcare Policies and Procedures. The Coding and Billing Compliance team is responsible for completion of coding and billing audits for physicians, urgent care centers, and oncology centers. The Outpatient Services Coding Audit Manager position will work on various audit engagements with team members at various levels and receive formal evaluations/feedback on job performance.

What you will do in this role:

• Performs Outpatient Services (Physician, Urgent Care Center, Free-standing Oncology Center, Imaging and Diagnostic Center) coding/billing audits and project reviews.
• Demonstrates a thorough understanding of complex outpatient services coding concepts, (including CPT, ICD-10, HCPCS), and auditing concepts; discusses complex coding and auditing issues with engagement team and client management; keeps informed of professional standards and company/department policies and procedures and effectively applies this knowledge to complex client situations.
• Manages work of Seniors and Staff.
• Manages audit engagements - including managing their individual time; scheduling and assigning work and monitoring the progress of audit fieldwork; and proposing modifications to current procedures to improve audit effectiveness and efficiency.
• Prepares performance evaluations for assigned mentees and staff/seniors.
• Communicates the objectives of a review and planned other services to the client engagement team and establishes/communicates team members' roles in the process.
• Stays abreast of general industry, regulatory and economic developments and applies their understanding to identify areas of audit significance.
• Assesses the degree of risk and the nature of the errors that could result from coding and billing errors, identifies unusual or unexpected transactions and processes, and demonstrates a broader understanding by recognizing business trends and emerging technical and industry developments of relevance to share with the client engagement team.
• Serves as a trusted business advisor by providing the client advice.
• Provides input and guidance in the development of, as well as the review of, the detailed audit/review programs and Interim Summary and Memorandum.
• Executes audit procedures in complex, judgmental and specialized areas of outpatient services coding.
• Analyzes evidence, reach conclusions, identifies issues and proposes strategies for complex, judgmental issues, as well as makes decisions related to moderately complex issues with regard to the review procedures executed. Consult with others in the Company, as necessary, on complex issues.
• Reviews working papers and memoranda prepared by Staff and Seniors for technical accuracy and completeness, as is consistent with generally accepted auditing standards, as well as the requirements of the department.
• Utilizes and encourages the application of HCA Healthcare and department computer-based audit tools.
• Shows initiative with new technology, systems, and automation.
• Prepares and delivers presentations to engagement team members (e.g. when conducting planning meetings) and client management (e.g., when participating in closing conferences).
• Prepares memoranda, working papers, and other documents in conjunction with serving the client (e.g., engagement letters, executive summaries, and other reports).
• Develops and maintains working relationships with client management and demonstrates a commitment to identify client needs and continually improve our client's satisfaction.
• Provides guidance to assist Staff and Seniors in reaching their full potential (e.g., willingly addresses questions, contributes constructive on-the-job feedback and training, conducts meaningful and timely performance reviews) and assists them in designing and implementing individual development plans.
• Fosters teamwork by maintaining cooperative relationships with client engagement teams (e.g. sharing Staff's and Senior's time with other engagement teams), contributing to positive work environments, facilitating the resolution of conflicts, sharing information, and accepting and providing constructive feedback.
• Understands the full range of department services and identifies ways to address the needs of the client.
• Maintains an education program to continually develop technical coding, Health Information Management (HIM), auditing and management skills consistent with the department's professional development requirements.
• Assists with other educational and administrative matters (e.g., professional development programs, process improvement team initiatives, recruiting efforts, and special projects).

Specific Testwork Performed

• Coding and Billing Compliance Audits of HCA Healthcare Facilities (Physicians, Urgent Care Centers, Free-standing Oncology Centers, Imaging and Diagnostic Facilities)
• Special Projects (high-risk coding/billing compliance projects)

What qualifications you will need:

• 6-8 years' experience (Outpatient Services Coding - Physician, Urgent Care, Oncology, or Diagnostic Imaging preferred)
• College Graduate preferred
• Certified as a RHIA, RHIT or CPC preferred
• Physician coding and/or coding quality monitoring experience helpful
• Ability to travel up to 25%

HCA Healthcare has been recognized as one of the World's Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"Good people beget good people."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.