Manager, Coding Compliance; Hybrid - Pediatrics

Position Summary

The Department of Pediatrics is seeking a progressive and skilled Manager of Coding and Compliance to oversee the coding function of a large, complex department of 15 divisions. The position handles the day-to-day operations of charge capture activities assuring compliance and maximizing revenue.

The Manager is responsible for overseeing a team reviewing complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. This leader will also assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letters, and other resolution mechanisms designed to obtain maximum reimbursement in a compliant way.

• Supervises Coding Coordinators to assure hospital based services captured timely and to maximize revenue.
• Directly interacts and communicates with faculty on coding, charge capture, compliance and other billing related issues.
• Perform compliance related duties such as review of medical documentation, completion of physician audits and OPBC audits.
• Develop educational material and conducts regular meetings with faculty to determine methods of improving coding and documentation.
• Assure staff attends scheduled training/in-services.
• Keeps abreast of procedures and changes affecting Medicare, Medicaid, HMO, PPO and related health care operations.
• Communicates policies and procedures to staff on billing issues to promote efficient flow of billing process.
• Monitors weekly charges, TES workfiles, MTC lists, approves write-offs per departmental policy.
• Assures weekly completion of hospital missing charge lists and report physician in noncompliance of divisional/departmental missing operative note policy.
• Assures OPBC and Departmental compliance guidelines applied to billed services.
• Creates TES and Medicode edits to reduce reductions; monitors TES workfile for aging encounters.
• Serves as compliance liaison to WU Office of Physician Billing Compliance.

• Normal office environment.

Physical Effort:
Typically sitting at a desk or table.

Equipment:
Office equipment.

Education: Bachelor’s degree or combination of education and/or experience may substitute for minimum education.

Certifications / Professional Licenses: No specific certification/professional license is required for this position.

Work Experience: Supervisory (5 Years)

Skills: Not Applicable

Driver’s License: A driver's license is not required for this position.

Education:

No additional education unless stated elsewhere in the job posting.

Certifications / Professional Licenses:
No additional certification/professional licenses unless stated elsewhere in the job posting.

Work Experience:

No additional work experience unless stated elsewhere in the job posting.

Skills:

Accounting, Code Compliance, Organizing, Supervisory Management, Trend Analysis, Trend Reporting

C13

$68,100.00 - $ / Annually

WashU seeks highly motivated individuals who are able to perform duties in a manner consistent with our core mission and guiding principles.

If you are unable to use our online application system and would like an accommodation, please email Candidate Questions or call the dedicated accommodation inquiry number at  and leave a voicemail with the nature of your request. All qualified individuals must be able to perform the essential functions of the position satisfactorily and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions of their job, absent undue hardship.

All external candidates receiving an offer for employment will be required to submit to pre-employment screening for this position. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or…