Supervisor Coding Validation

SUMMARY

Reports to PFS Manager of Coding Policy and Education. Assists Manager in providing feedback and education to coders and providers. Assists Manager with coordinating external audits and internal audits.

Brown University Health employees are expected to successfully role model the organization’s values of Compassion, Accountability, Respect, and Excellence, as these values guide our everyday actions with patients, customers, and one another.

In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:

• Instill Trust and Value Differences
• Patient and Community Focus and Collaborate

In addition, our leaders will demonstrate an aptitude for:

• Ensure Accountability and Build Effective Teams
• Drive Vision and Purpose and Optimize Work Processes

By applying core and leadership competencies, leaders help Brown University Health achieve its strategic goals.

RESPONSIBILITIES

Performs audits of the validation team to assure all validation is consistent with coding guidelines and Brown University Health’s billing, coding, and compliance policies. Works with Manager to create annual validation schedule and validator goals. Ensures validators are performing timely and accurate audits and are meeting all goals of the department.

Provide regular feedback to staff, including praising them for their successes and mentoring/retraining as needed. Identifies coding trends and reports these trends to the Manager. Maintains updated knowledge of all billing, coding, insurance, and compliance guidelines, including but not limited to HiPAA, CPT, ICD-10, HCHPCS, medical terminology, etc. Applies this knowledge daily and serves as a resource to staff.

Serves as the principal trainer to new staff and a resource to the team, answers questions and provides guidance. Oversees the development and growth of the individual validators. Acts as a resource for healthcare professionals in need of coding/documentation assistance. Assists Manager with human resource issues including hiring, evaluating, implementing improvement/corrective action plans, and terminations, as needed. Prepares payroll as requested.

Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and the American Association of Professional Coders. Monitors validators for violations and reports to PFS Manager or Director when areas of concern are identified. Performs other duties as necessary.

MINIMUM QUALIFICATIONS

BASIC KNOWLEDGE: Associate Degree or 3 years of experience in a medical coding/validating role. Certification required: CCS, CPC. RHIA or RHIT considered.

EXPERIENCE: Three to five years progressively responsible experience performing outpatient coding. Experience in a large, multispecialty physician group and/or complex academic medical center preferred. One to two years supervisory experience strongly preferred. Experience should demonstrate a high level of knowledge in ICD-10-CM and CPT-4 coding methodologies. Effective written and oral communication skills and effective leadership/management skills required. Experience with Epic preferred.

WORKING CONDITION AND PHYSICAL REQUIREMENTS: This position is Remote in Providence, RI.

INDEPENDENT ACTION: Performs independently within the department’s policies and procedures. Refers specific complex problems to the Manager when clarification of the departmental policies and procedures are required.

SUPERVISORY RESPONSIBILITY: Supervisory responsibility for up to 20 FTEs.

Pay Range

$71,136.00 - $117,353.60

Location

Corporate Headquarters - 15 LaSalle Square Providence, Rhode Island 02903

Work Type

M-F Days

Work Shift

Day

Daily Hours

8 hours

Driving Required

No

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.