Provider Coding Compliance Education Supervisor

Position Details

Lakeland Regional Health is a leading medical center located in Central Florida. With a legacy spanning over a century, we have been dedicated to serving our community with excellence in healthcare. As the only Level 2 Trauma center for Polk, Highlands, and Hardee counties, and the second busiest Emergency Department in the US, we are committed to providing high-quality care to our diverse patient population. Our facility is licensed for 910 beds and handles over 200,000 emergency room visits annually, along with 49,000 inpatient admissions, 21,000 surgical cases, 4,000 births, and 101,000 outpatient visits.

Work Hours per Biweekly Pay Period : 0.00

Shift : Days

Location : 210 South Florida Avenue Lakeland, FL

Pay Rate : Min $70,324.80 Mid $87,900.80

Position Summary

Under the direction of the Associate Vice President of Health Information Management, the Provider Coding Compliance Education Supervisor is responsible for developing, updating, implementing, and managing a Provider Coding Compliance Education Plan to ensure accurate and compliant medical coding and billing practices consistent with CMS, Office of Inspector General (OIG), ICD-10 Official Guidelines for Coding and Reporting, and other applicable rules or guidelines. The Supervisor will oversee and provide coding, documentation, and general compliance education as it applies to providers; and identifies, validates, and ensures professional billing and coding compliance for providers through the evaluation of billing patterns, routine audits, and comprehensive educational sessions focusing on areas of specialty and risk assessment. The Supervisor is responsible for developing and implementing ongoing coding training and auditing of medical record documentation to ensure compliance; providing education; providing assessment and tracking of documentation compliance and improvement; and monitoring the need for process improvements or enhancements.

The Supervisor will evaluate new patient services, appropriate billing, documentation, and reimbursements to ensure maximization of revenue in a compliant environment. The Supervisor will oversee the review of all new, onboarded providers to validate and ensure coding and billing compliance as well as provide immediate feedback and education. The Supervisor will provide consultative services to clinical practices to include evaluation of services provided, appropriate coding and billing, and documentation. The Supervisor will be included with third-party payer coding reviews and documentation findings with follow-up of recommendations.

The Supervisor will oversee the risk adjustment program which is responsible for ensuring proper risk adjustment coding by performing audits of providers; ensuring accurate representation of the care provided; ensuring accuracy in the HCC codes reported; and provider education.

The Supervisor will work collaboratively with Corporate Integrity Services and the Revenue Cycle Management personnel such as the LRHPG Coding Manager and the Director of Clinical Documentation Integrity to standardize provider documentation education efforts. The Supervisor will also work collaboratively with the Providers, staff, and others as may be deemed appropriate.

Qualifications & Experience

Essential :

High School or Equivalent

Experience Essential :

5+ years of coding and auditing experience; knowledge of and working experience in professional billing and healthcare reimbursement and coding experience.

5+ years prior supervisory / management experience or in a coordinator / lead role.

Certification Essential :

CPC, CCS-P, or CCS with two or more additional AAPC Specialty Medical Coding Certifications

Certification Preferred :

AAPC Certified Professional Medical Auditor (CPMA), Certified Evaluation and

Management Coder (CEMC), Certified Risk Adjustment Coder (CRC)

Position Responsibilities

People At The Heart Of All That We Do

• Fosters an inclusive and engaged environment through teamwork and collaboration.
• Ensures patients and families have the best possible experiences across the continuum of care.
• Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created.

Safety And Performance Improvement

Stewardship

Standard Work : Provider Coding Compliance Education Supervisor

Competencies & Skills

Essential :