The Coding Compliance/Quality Supervisor demonstrates the ability to achieve individual quality performance in daily duties is team oriented and seeks to produce timely and high quality results.

Reports to the MMG Coding and Reimbursement Manager.  This position is accountable reviewing and seeking patterns in claim denials.  This position will enact a Coding Compliance Plan, which will include coding audits and conducting educational meetings with providers. Must keep an open line of communication with all staff required to fulfill your job duties.

QUALIFICATIONS:

• CPC required or three years’ experience in professional coding.
• Extensive understanding of CPT professional coding, ICD-10-CM and HCPCS. 

EDUCATION:

• High School Diploma or GED

EXPERIENCE:

• Three years experience in professional coding.
• Computer literacy essential.
• Experience in billing cycle, professional coding and compliance required.
• Knowledge of working front end errors and denials.

KNOWLEDGE AND SKILLS:

• Has broad, fairly detailed level of knowledge of CPT professional coding, ICD-10-CM and HCPCS.
• Gathers, organizes, verifies, composes, and/or analyzes data in the completion of several defined, multi-step procedures.
• Produces final output within established standards.
• Analyzes and interprets complicated information.
• Determines a course of action based on insurance and coding regulations.
• Proficient in Microsoft Office and Microsoft Excel.

PRINCIPAL JOB ACCOUNTABILITIES:

1. Identify, compile and code patient data, using ICD-10-CM, CPT and other standard classification coding systems.
2. Responsible for communication between the Coding Department, Clinic Managers, and the CBO regarding denials and rejections that are related to coding errors.
3. Assessing, researching and correcting all coding errors or directing to the appropriate coder for that clinic/specialty.
4. Review records for completeness, accuracy and compliance with regulations.
5. Create and implement a Coding Compliance Plan.
6. Routinely audit office visits notes, operative reports, hospital documentation for each provider.
7. Maintains positive working relationships with staff, physicians and residents to achieve patient, staff and physician satisfaction and continuous group performance improvement. 
8. Continuously encourages process improvement in all areas.  Actively identifies opportunities for process improvement.  Implements plan to improve and monitors processes to ensure results are achieved. 
9. Communicates effectively and in a timely and professional manner with all internal and external employees.
10. Identifies and participates in quality improvement processes.
11. Demonstrates awareness of patient rights.
12. Demonstrates ability to prioritize responsibilities according to job duties and staffing demands. 
13. Protect the security of medical records to ensure that confidentiality is maintained.

JOB ACCOUNTABILITIES – Other:

1. Develops, communicates and implements appropriate departmental policies and procedures.
2. Collaborates with support departments to ensure accuracy. 
3. Participates, when required, with site review by auditors, surveyors or managed care organizations. 
4. Implements improvements and recommendations based on internal and external audits. 
5. Works to achieve continuous quality improvement and performance in all areas of responsibility.
6. Maintains professional growth and development through seminars, workshops and professional affiliations.  Takes responsibility to remain current with all required educational information, literature and memorandums.
7. Performs other duties as requested by management.