We have been voted a top Central Texas employer by our employees for 13 years! We have 26 locations and are one of central Texas’ largest professional medical groups. We offer the following benefits to eligible team members: Medical, Dental, Vision, Flexible Spending Accounts, Time Off, 401(k), EAP, Life Insurance, Long Term Disability, Tuition Reimbursement, Child Care Assistance, Health & Fitness, Sick Child Care Assistance and Development. For more information visit https://www.austinregionalclinic.com/careers/.
Responsible for creating and nurturing a culture of partnership and educational development that drives coding excellence and a spirit of integrity in the revenue cycle process. Directs the Coding Quality department staff responsible for ensuring compliance with company policies and procedures, tracking and auditing provider coding practices to ensure optimal legal charging for services, monitoring legal regulations and providing education for the organization of any changes. Coordinates shared activities and accountability with operations, clinical leadership, revenue cycle management and staff, and other departments to promote optimal coding and documentation performance. Carriers out all duties while respecting patient confidentiality and promoting the mission and philosophy of the organization supported.
Leads the Coding Quality team.
Manages and develops coding quality staff, ensuring adequate general and specialized additional training opportunities as needed.
Maintains close relationships and collaborates with Insurance Follow-up and Revenue Integrity teams in the CBO, Operations Directors, and Clinic and Business Office Managers.
Organizes the agenda and leads Coding Quality team meetings.
Attends and actively participated in Business Office Manager meetings and the Business Operations Group.
Administrator for organization’s subscriptions for EncoderPro, AMA CPT Codebooks and guidelines and other coding and compliance memberships or journals.
Timely identifies CPT, HCPCS and ICD code additions, deletions and changes affecting ARC providers and communicates concise and easily understood information to affected department chiefs, operations directors and clinic management, and the CBO as appropriate in a focused communications of those changes affecting each department.
Maintains membership in professional organizations and attends relevant conferences and seminars to stay current on coding and compliance management best practices; supervises attendance of conferences and seminars by coding quality staff to ensure excellence of knowledge and insight for relevant specialties.
Provides oversight in coding education for new hires (including providers) and the annual education on compliance and privacy (in connection with Learning and Development).
Communicates identified areas of increased risk or scrutiny by regulators to those affected.
Assistant Compliance Officer
Assists Compliance Officer with oversight of the Austin Regional Clinic (ARC)/Covenant Management System (Covenant) Compliance Program, functioning as an objective investigator, auditor and evaluator of compliance issues/concerns within ARC/Covenant and, as directed by the Compliance Officer, implementer of any policy or process changes required in collaboration with leaders of other departments.
Assists with the development and maintenance of policies and procedures for the general operation of the Compliance Program and its related activities to prevent illegal, unethical, or improper conduct. Acts as responsible person for gathering and reporting results of the compliance efforts.
Develops annual compliance work plans based on identified risks for the health care industry, medical groups, and/or internal activities and to assess compliance vulnerability. Implements focused chart reviews and other procedures as appropriate to monitor compliance and control effectiveness to address these areas of risk and vulnerabilities.
Monitors, and as necessary, coordinates compliance activities of ARC/Covenant facilities and divisions to remain abreast of the status of compliance activities and to identify trends.
Organizes annual chart reviews for physicians in various settings and communicates audit results to physicians, center managers, leadership and ancillary staff; performs sample reviews of audits to validate quality results. Conducts or directs special reviews of charts as needed for specific identified concerns.
Works with the Compliance Officer in preparing an agenda for the quarterly Compliance Committee & semi-annual Executive Advisory group meetings.
Collaborates with the ARC/Covenant Compliance Officer and by other means to direct compliance issues to appropriate channels for investigation and resolution.
Works with the Learning and Development Department and others as appropriate to maintain an effective compliance training program, including appropriate introductory training for new employees as well as ongoing training for all employees and managers, monitoring completion rates, and taking appropriate action in accordance with policy for anyone not completing required training.
Responsible for monitoring employee and public reports of compliance concerns.
OTHER DUTIES AND RESPONSIBILITIES
Represents Covenant and ARC in community and industry organizations.
Adheres to all company policies, including but not limited to, OSHA, HIPAA, compliance and Code of Conduct.
Regular and dependable attendance.
Follows the core competencies set forth by the Company, which are available for review on CMSweb.
Works closely in partnership with Department Chiefs, Providers, Regional Directors, Managers, and others as appropriate to develop an appropriate culture of responsibility for optimizing coding quality and to effect training solutions for identified correct coding deficiencies.
Performs other duties as assigned.
Education and Experience
Required: Bachelor’s degree in related area, MBA or MHA preferred. Five (5) or more years of experience in a leadership role in a medical group business environment, including experience coordinating a compliance program and experience with procedural and diagnostic coding. Significant experience leading teams, both in a formal reporting structure and informal task-oriented groups.
Knowledge, Skills and Abilities
Ability to communicate clearly and effectively with all levels of areas of the organization, i.e., physicians, senior management, and business office staff, enhance cooperation and build consensus for continuous improvement in areas of responsibility.
Must display professional commitment to stay in the loop on the ever-changing landscape that is the business side of health care by participating in on-going continuing education training in coding and compliance.
Knowledge of coding and compliance auditing concepts and principles.
Ability to use independent judgment and to manage and impart confidential information.
Advanced knowledge of medical coding and billing systems and regulatory requirements.
Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation.
Knowledge of current and developing issues and trends in medical coding procedures requirements.
Detailed knowledge of medical coding systems, procedures, and documentation requirements.
Ability to adapt and modify medical billing procedures, protocol, and data management systems to meet specific operating requirements.
Ability to manage and train staff in area of expertise.
Knowledge of human resource fundamentals and underlying laws, i.e., FLSA, ADA, FMLA, etc.
Proficient PC skills including knowledge of Microsoft Office programs and familiarity with Windows.
Strong analytical and problem-solving skills.
Ability to analyze and interpret financial and statistical data/reports.
Ability to engage others, listen and adapt response to meet others’ needs.
Ability to align own actions with those of other team members committed to common goals.
Excellent verbal and written communication skills.
Ability to manage competing priorities.
Ability to perform job duties in a professional manner at all times.
Ability to understand, recall, and communicate, factual information.
Ability to understand, recall, and apply oral and/or written instructions or other information.
Ability to organize thoughts and ideas into understandable terminology.
Ability to apply common sense in performing job.
Must possess nationally recognized coding certification (or equivalent extensive experience and willingness to pursue certification). Certification by Health Care Compliance Association (HCCA) preferred.
Additional Salary Information: Competitive Pay
Internal Number: Coding
About Austin Regional Clinic
Austin Regional Clinic has been voted a top Central Texas employer by our employees for 11 years! We have 24 locations and are one of central Texas’ largest professional medical groups. We offer the following benefits to eligible team members: Medical, Dental, Vision, Flexible Spending Accounts, Time Off, 401(k), EAP, Life Insurance, Long Term Disability, Tuition Reimbursement, Child Care Assistance, Health & Fitness, Sick Child Care Assistance and Development. For more information visit https://www.austinregionalclinic.com/careers/.