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Manager of Coding and Compliance

Company : Caritas Christi Healthcare System

City: Brighton

State: MA

ZIP: 02135

Posting Date: July 18, 2008

Type of Position: Allied Health

Company Profile

Company Name:Caritas Christi Healthcare System

Description

Established in 1985, Caritas Christi Health Care, the second largest health care system in New England, is a comprehensive, integrated health care delivery network providing community-based medicine and tertiary care in eastern Massachusetts, southern New Hampshire and Rhode Island.

Each member of the Caritas Christi system, while a member of a community of health care providers, has its own rich history of providing outstanding, compassionate care and respect for the dignity of those served.

The acute care hospitals of Caritas Christi include: Caritas St. Elizabeth's Medical Center, Brighton; Caritas Carney Hospital, Dorchester; Caritas Good Samaritan Medical Center, Brockton; Caritas Holy Family Hospital and Medical Center, Methuen; Caritas Norwood Hospital, Norwood; and Saint Anne's Hospital, Fall River.

Primary BusinessHospital

Job Description

About us:

Each member of the Caritas Christi system, while a member of a community of health care providers, has its own rich history of providing outstanding, compassionate care and respect for the dignity of those served.

At the hub of the system's six-hospital network is Caritas St. Elizabeth's Medical Center of Boston, a tertiary academic teaching hospital affiliated with Tufts University School of Medicine. The other acute care hospitals in Massachusetts are Caritas Carney Hospital, Dorchester; Caritas Good Samaritan Medical Center, Brockton; Caritas Holy Family Hospital and Medical Center, Methuen; Caritas Norwood Hospital, Norwood; and Saint Anne's Hospital, Fall River.

Non-acute Caritas Christi facilities, which provide social, educational or health care services, include Caritas Home Care, Caritas Good Samaritan Hospice, Caritas Labouré College, Caritas St. Mary's Women and Children's Center and Por Cristo, an international volunteer medical services organization.

In addition the system includes Caritas Physician Network, a 400-physician group practice

Facility: Caritas St. Elizabeth's Medical Center, Boston MA
Department: Coding & Analysis
- Full-time - 40 hrs/wk, Monday - Friday, 8:00am - 5:00pm
- Day shift
- Certification is required.
- 3-5 years experience is required.

**********$10,000.00 Sign-On Bonus***********

Job Description:St. Elizabeth's Medical Center, our flagship hospital, and member of Caritas Christi, the second largest healthcare system in New England, is seeking an experienced Manager of Coding and Compliance. Reporting to the Director of Medical Records, as a self-starter with a strong work ethic, and background working in a fast-paced environment, you will be charged with monitoring the quality of coding, abstracting, data entry and compliance with external regulatory agency requirements with respect to proper coding, documentation and reporting. Manage daily operations of the coding area to ensure timely, accurate coding of inpatient and out patient encounters as substantiated by the documentation in the medical record, contributing to optimal reimbursement. Oversee and train a staff of eight full-time employees (FTE's), on documentation guidelines, coding principles and conventions and computer systems, and train the medical staff on documentation guidelines as they relate to accurate code, DRG and/or APC assignment. Key Initiatives:- Monitor coding, abstracting and data entry for accuracy with the use of various Meditech reports, and assign ICD-9-CM and CPT-4 codes to discharged inpatient and outpatient medical records.- Monitor DRG maximization efforts to ensure optimal DRG and third party reimbursement.- Generate and submit monthly reports to the Director of Medical Records.- Oversee, train, and mentor eight FTE's, providing on-going in-service education on updates, revisions, and deletions of codes and coding guidelines, and correct coded information to ensure compliance with Rate Setting and other external data requirements.- Conduct routine random audits of coding practices (inpatient and outpatient care) to ensure compliance with various documentation guidelines, coding principles and conventions, and assist in the departmental Quality Improvement (QI) program by monitoring QI forms and assisting the Coding Validator in the audit process.- Act as a liaison to the Utilization/Care Management, Patient Access, Patient Finance and Information Services departments to maintain a timely billing schedule, and act as a liaison to the Medical Staff with regards to coding, DRG and denial/appeal issues when necessary.- Perform audit process (MassPRO and Blue Cross), prepare all necessary records, reserve space, obtain necessary documentation for on-site review, appeal denials where appropriate, and maintain summary sheets on cycles.- Perform other projects as assigned. Qualifications:- Must have 3-5 years of coding experience in a Medical Records department within an acute care setting, preferably a teaching facility- Thorough knowledge and significant experience in ICD9/CPT4 coding, DRG assignment and CMS compliance issues- An active member of the American Health Information Management Association- Experience with coding software, including groupers, editors, optimizers and encoders- Strong leadership, technical, analytical, and communication skills are required- Must have certification as a Certified Coding Specialist (CCS), and either a RHIA or and RHIT - Experience with Meditech, 3M, and Microsoft Office is preferred We offer a comprehensive benefits and compensation package and a fast-paced work environment.

Caritas St. Elizabeth's Medical Center is an equal opportunity employer.

Job Responsibilities

Job Benefits

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