Tidelands Health

Learning and Development

• Oversee staff education, support role transitions, and provide training and resources
• Participate in nursing research, share results, and integrate new findings into clinical practice
• Program development and leadership for at least one facet of the Organizational Development Department
• Provide consultation, tailor plans, develop recommendations and act as a change agent regarding nursing education needs and roles
• Facilitate a variety of educational programs encompassing all levels of ability and needs of the organization personnel, especially those requiring clinical expertise
• Participate in planning and implementation of educational offerings and opportunities
• Ensure policy and procedures, competencies, equipment and supplies needed for education offerings are current and operational to provide optimal education experience

Nursing Professional Development Practitioner, RN

Medical Billing and Coding

• Leads and guides staff that performs medical coding functions and supervises the processes and systems required to accomplish timely, accurate, and compliant record management and coding.
• Supervise and coordinate all activities of the medical coders to include effective management of staffing schedule to achieve timely coding, provider and coder audits, identification of and implementation of proactive denial mitigants, and staff engagement.
• Responsible for maintaining current knowledge of applicable medical record and coding laws, rules, and regulations, Follows compliant charge capture in accordance with Medicare, Medicaid or Third-Party payer guidelines.
• Assists with development of policies, procedures and job aids related to coding and charge entry.
• Assist in the development of processes and education of team related to provider coding.
• Translates regulatory requirements into daily operating procedures.
• Assists with the preparation of special reports for Leadership to document utilization of the charge capture outcomes (e.g., late entry volumes, pricing impacts, etc.).
• Assists with and works in cooperation with CDM managers to establish charge capture, CDM maintenance practices and methodologies.
• Recommends revisions to charge codes and submits requests for charge codes for new services.
• Support ongoing education needs of employee-partners to keep all apprised of most current coding regulations and guidance.
• Educates caregivers on charge capture as omissions or errors are identified.
• Supervise daily revenue cycle operations to include creation, monitoring and problem-resolution needed to achieve agreed upon revenue cycle metrics for the coding team
• Work with physicians to ensure consistent coding and documentation policies and procedures are followed.
• Act as a resource to clinic staff on matters pertaining to the revenue cycle.
• Identifies inconsistencies and works with Clinical Informatics to streamline charge capture process.
• Lead or participate in cross-functional workgroups/committees as needed.
• Support all other functions of the Revenue Cycle Team.
• Will work with HR, IT Provisioning team, and coding manager/director in all aspects of onboarding new employees.

Supervisor, Provider Coding Specialist

• Responsible for analyzing and assigning ICD-10-CM diagnostic codes, CPT, and HCPCS codes to all outpatient, ED, and hospitalists accounts
• Abides by the Standards of Ethical Coding as set forth by AHIMA and AAPC
• Abstracting required clinical information from the medical record
• Queries physicians as needed, to clarify documentation to ensure accurate code assignment
• Organizes and prioritizes work to meet deadlines and goals
• Maintains and expands knowledge of coding and sequencing guidelines to ensure coding compliance and accuracy
• Responsible for resolving coding edits, account checks, rejections, and denials to ensure proper reimbursement of service rendered
• May assist with writing appeals letters
• Assist with training to include team members and physicians
• Collaborate with the Compliance/Quality Team when alerted to coding quality issues found via internal or external reviews

Nursing Professional Development Practitioner, RN

Supervisor, Provider Coding Specialist

Medical Coder – Coding Specialist