Supervisor, Professional Coding Audit & Education

At Children’s Wisconsin, we believe kids deserve the best. Children’s Wisconsin is a nationally recognized health system dedicated solely to the health and well-being of children. We provide primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family resource centers. Our reputation draws patients and families from around the country.

About the role

Supervises the Professional Coding Auditor Team. Ensures that Audits are accurate and performed based on the Auditing timeline guidelines. Requires thorough knowledge of both medical coding and auditing. Should have extensive experience with auditing of medical coding along with advanced experience with electronic medical records and excel.

Responsibilities

• Leads Audit activities to ensure accuracy, consistency, and timeliness in the Professional Audit team
• Monitors key departmental metrics in quality, efficiency, and production
• Collaborates with Revenue Cycle Leaders as well as leaders in the clinical areas
• Serves as a subject matter expert for all auditing activities and demonstrates expert knowledge in evaluation and management coding as well as multiple relevant specialty areas
• Maintains current knowledge of coding rules and guidelines and provides guidance on requirements established by CMS, payers, professional coding organizations and medical specialty professional organizations
• Coordinates and performs training for team members as needed
• Demonstrates knowledge of organization safety policies and procedures and actively maintains a safe and positive work environment
• Works with Professional Coding Coordinator to ensure timely processing of scheduling of Provider training as well as Provider Audits
• Performs human resources responsibilities for staff which includes coaching on performance, completes performance reviews and overall staff morale
• Recommends hiring, terminations, compensation changes, promotions, corrective action decisions, and terminations
• Performs people management responsibilities for employees which may include but are not limited to: employee engagement, recruitment, performance management and development
• Responsible for understanding and adhering to the Children’s Organizational Code of Ethics and for ensuring that personal actions, and the actions of employees supervised, comply with the policies, regulations and laws applicable to Children's business

Requirements

• High School graduate or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED) required
• Coding certifications specific to outpatient professional coding required
• Associate's Degree or Bachelor's Degree preferred
• 2+ years of coding leadership experience demonstrating progressive responsibilities required
• Recent experience applying ICD-10-CM, CPT and HCPCs codes required
• Recent experience in performing Coding Audits for Providers or Coders required
• Three or more years of Coding Audit leadership experience demonstrating progressive responsibilities preferred

Skills

• Exhibits excellent customer service and professionalism when interacting with providers, staff, patients, families and co-workers to ensure all are treated with kindness and respect
• Professional attitude and ability to relate to and interact with others throughout the organization
• Demonstrates leadership skills, organizational skills, and conflict resolution skills
• Must be able to work collaboratively in a team environment
• Must be able to work effectively in a remote environment
• Must have excellent attention to detail ability
• Exhibits a commitment to continuous quality improvement

Licenses and Certifications

One of the following:

• CCS-Certified Coding Specialist - American Health Information Management Association
• CPC-Certified Professional Coder - American Board of Professional Coders
• CCS-P-Certified Coding Specialist Physician Based - American Health Information Management Association
• RHIA-Registered Health Information Administrator - American Health Information Management Association
• RHIT-Registered Health Information Technician - American Health Information Management Association