Job: Coding & Credentialing Supervisor

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Job Description

Job Title:                     

Coding & Credentialing Supervisor

Reports To:                 

Business Office Manager

Job Summary:                 

 To supervise the activities of the coding/credentialing staff and

  to assist the Business Office Manager and Chief Financial Officer in improving the financial strength of CCHCI.


Qualifications and Requirements:

To perform this job successfully, and individual must be able to perform each essential job duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  This job description in no way implies that these are the only duties to be performed and may be modified, interpreted and/or applied in any way as necessary. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.


Essential Job Duties:

  • Ensures all coding/credentialing tasks necessary to maximize revenue and efficiency are performed.
  • Supervises coding/credentialing personnel.
  • Provides support to the Business Office Manager.
  • Assists in gathering data, ensuring the accuracy of data gathered and provides the data to internal and external auditors as required.
  • Ensures that Month End closings are completed in a timely and accurate manner.
  • Reviews/ensures un-submitted and unbilled charges are current at the Month End.
  • Conducts routine internal audits of charges and adjustments, credentialing, and privileging files.
  • Assists in oversight of the Practice Management System.
  • Assists in financially supporting operational and strategic activities.
  • Ensures that clearing house items are addressed on a daily basis.
  • Ensures that charges and payments are posted daily.
  • Manages denials to identify causes, corrective actions and ensures timely resubmission.
  • Assists Health Center Managers/directors in addressing unbilled encounters and un-submitted charges.
  • Ensures providers are credentialed and privileged in a timely manner.
  • Provides oversight, support, direction and development of Coding/Credentialing Staff.
  • Conducts routine staff meetings.
  • Participates in training related to documentation, coding, credentialing and billing compliance and updates to the Practice Management Software.
  • Participates in collaborative meetings/trainings as available and necessary.
  • Facilitates staff development through internal and external training
  • Develops opportunities for growth and advancement within the department.
  • Develops and conducts provider training pertaining to coding and documentation.
  • Assists in assigned projects/duties.


Required Education, Experience, Certificates & Licenses:

  • Associates and/or Bachelor’s degree in business, health administration, or related field.
  • Three or more years of experience in Coding.
  • Three or more years of experience in Credentialing preferred.
  • Supervisory experience preferred.
  • Any combination of education and/or experience that provides the necessary combination of skills and sensitivity.
  • Certified Professional Coder required.


Required Language Skills:

  • Ability to comprehend and compose effective instructions, correspondence and communications in English in both oral and written format.
  • Ability to effectively present information in one-on-one and small group situations to patients, internal providers and staff and other agency staff working in cooperation with the organization.


Physical Requirements:

  • Ability to occasionally exert enough force to move objects weighing up to 10 pounds.
  • Ability to continuously remain in a stationary position.
  • Ability to occasionally move about inside the work place to access files, office machinery, etc.
  • Possesses hand-eye coordination and manual dexterity necessary to constantly operate computer, telephone, and other office machinery.
  • Possesses close visual acuity necessary to accurately record and view information on a computer monitor, handwritten and typed documents.
  • Ability to discern the nature of sounds at a normal spoken volume.


Other Required Knowledge, Skills, and Abilities:

  • Ability to add, subtract, multiply and divide in all measure, using whole numbers, common fractions and decimals.
  • Ability to compute rate, ratio and percent and to draw and interpret graphs.
  • Ability to skillfully gather and analyze data.
  • Ability to perform a variety of assignments and make decisions requiring considerable independent judgment.
  • Displays high level of critical thinking and problem solving skills.
  • Displays sound and accurate judgment and ability to make timely decisions.
  • Knowledge of medical coding, billing, medical records, health plans, and community health centers preferred.
  • Knowledge of HIPAA and Corporate Compliance rules and regulations.
  • Computer literacy required with proficiency in use of all Microsoft Office programs.
  • Knowledge of Electronic Health Records preferred.
  • Ability to prioritize and plan work activities, use time efficiently and develop realistic action plans.
  • Ability to employ motivational techniques to train, mentor and lead staff.


Work Environment & Conditions:

  • Work environment is usually typical of an administrative office setting with no substantial exposure to adverse environmental conditions.
  • Frequently, work requires extended hours to include early mornings, evenings and weekends.