Manager, Revenue Integrity-Coders

Responsible for working of NCCI and Medical Necessity edits for all outpatients. Recommend and coordinate implementation of process improvements related to charge capture, CDM accuracy, revenue enhancements and compliance audits. Provides education to clinical department staff regarding CPT codes, HCPCS codes, Revenue Codes, modifiers and their proper use. Serves as a resource to Patient Financial Services regarding payer rejections and claims review process to ensure compliant, appropriate reimbursement.

Key Accountabilities

• Provide education to Revenue Integrity Coders.
• Monitor working of NCCI and Medical Necessity edits for all payers.
• Work with clinical departments to ensure appropriate, compliant charging occurs within the Norton Healthcare System.

Required:

• Three years inpatient coding
• Bachelor's degree
• One of: CCA or CCS or CIC-ICD or COC or CPC or RHIA or RHIT

Desired:

• One year management and training
• Certified Coding Associate OR Certified Coding Specialist OR Certified Inpatient Coder ICD-10 OR Certified Outpatient Coding OR Certified Professional Coder OR Registered Health Information Administrator OR Registered Health Information Technician