Nuvance Health is a family of award-winning nonprofit hospitals and healthcare professionals in the Hudson Valley and western Connecticut. Nuvance Health combines highly skilled physicians, state-of-the-art facilities and technology, and compassionate caregivers dedicated to providing quality care across a variety of clinical areas, including Cardiovascular, Neurosciences, Oncology, Orthopedics, and Primary Care.
Nuvance Health has a network of convenient hospital and outpatient locations — Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York — plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology care, and two urgent care offices. Non-acute care is offered through various affiliates, including the Thompson House for rehabilitation and skilled nursing services, and the Home Care organizations. For more information about Nuvance Health, visit www.nuvancehealth.org.
Title: Coding Supervisor
Reports To: Manager of Corporate Coding
Department: Health Information Management
FLSA Status: Salary
Purpose: Responsible for leading and supervising the coding (inpatient or Outpatient) staff. Ensures coders meet productivity and quality standards while maintaining DNFC expectations. Assist with development and implementing training, auditing and continuing education programs for the coding staff.
Maintains the day-to-day activities in the coding area to ensure all cases are coded and abstracted in an accurate, timely manner according to NH Coding Department Performance Metrics: PRODUCTIVITY METRIC
INPATIENT – 12.75 days per hour
AMBULATORY SURGERY – 12 Minutes/Record (5 records per hour)
OBSERVATION – 15 Minutes/Record (4 records per hour)
ONCOLOGY, PEDIATRIC INFUSIONS – 5 Minutes/Record (12 records per hour)
SPECIAL PROCEDURES (CARDIAC CATH, IRAD) – 15 Minutes/Record (4 records per hour)
ED – 5 Minutes/Record (12 records per hour)
Maintains adequate staffing and coverage for optimal performance of coding area activities.
Monitor the volume of coding within the department daily and adjust staffing/priorities as need to meet DNFC expectations.
Maintain daily coder productivity for each coder to ensure that set productivity standards are being met.
Ensures that staff members are aware of their productivity and how it relates to the standards.
Counsels employees who are not meeting their productivity standards.
Documents and submits productivity statistics by coder to the Manager at the end of each month.
Monitors DNFC cases and Coordinates with the Coding Coordinator to follows up on un-coded cases as necessary.
Codes as needed to meet DNFC goals
Remains abreast of all applicable Federal, State, regulatory and hospital-specific coding
Assists coders in accessing and researching applicable reference materials to further support decision-making in code selection.
Serves as a resource for department managers, staff, physicians and administration to obtain information or clarification on accurate and ethical coding and documentation standards, guidelines, and regulatory requirements.
Consults with Manager of Coding on interpretation and implementation of NH Internal Coding guidelines
Reviews and resolves Revenue Cycle edits and denials
Coordinates with Coding Coordinator to distribute and complete Revenue Cycle edits timely
Reviews claim denials and rejections pertaining to coding and medical necessity issues and, when necessary, implement corrective action plan, such as educational programs, to prevent similar denials and rejections from recurring.
Review and appeal as necessary all Medicare, RAC, insurance DRG denials
Review quarterly NH Pepper reports, review outliers and report findings to Coding/HIM Management.
Participates in Performance Improvement/Quality Assurance activities.
Participates in reconciliations of CDI DRG assignments. Serves as a point person to review & resolve CDI/Coder DRG differences.
Assists in addressing DRG and other coding related inquiries.
Reports on software and hardware problems and follows-up on same until matter is resolved.
Responsible to train and monitor new coding staff to ensure proper application of coding guidelines.
Provides on-going feedback with Clinical Documentation Improvement team on status of needed documentation to code properly.
Works with System Business office to ensure billing edits & denials are corrected according to official coding guidelines
Monitors the Coding Manager queue to assure cases are reviewed timely and education provided to the coder.
Leadership Skill Requirements
Maintain and Model REACH Values: (Respect, Excellence, Accountability, Compassion, Honor).
Action and Results-Oriented: Ability to establish goals and drive results amongst subordinate staff.
Ability to Build Relationships Through Integrity and Trust: Ability to quickly gain the trust and respect of others, drive collaboration, build a teamwork environment, search for the win/win scenarios.
Ability to lead using influence, rather than possessing direct authority over others.
Ability to be sensitive, yet direct in both verbal and written communications.
Education and Experience Requirements:
High School Diploma, courses in Anatomy and Physiology, Medical Terminology, ICD-10-CM, CPT 4, Disease Pathology.
Must have a minimum of 5 years acute care coding experience. Working knowledge of encoders and must be computer literate
Minimum Knowledge, Skills and Abilities Requirements:
Experience with Microsoft Word and Excel
Demonstrates skill and efficiency with respect to training and education tools and development.
Ability to manage project assignments from both a task and resource perspective
License, Registration, or Certification Requirements:
CCS and/or CPC required
PREFER: Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) certification through the American Health Information Management Association.