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Supervisor Revenue Integrity - (Telecommute - Must Reside in TX)

Location: Telecommute
Job Ref:
68139
Talent Area:
Leadership Management
Job Shift:
1st - Day
Job Type:
Full-Time
Posted Date:
March 11, 2025

At Houston Methodist, the Supervisor Revenue Integrity position is responsible for charge capture and physician onboarding. This position performs coding quality audits of medical records to assure appropriateness and accurate code assignments in accordance with Center of Medicare and Medicaid (CMS) guidelines, Current Procedural Terminology (CPT) guidelines and Houston Methodist policies and procedures. Additional responsibilities include supervising, tracking, and facilitating policies and procedures for reimbursement while maintaining patient and physician satisfaction.



The supervisor position responsibilities include overseeing the daily work activities of the work unit/department staff, ensuring quality, productivity, functional excellence and efficiency. This position trains and supervises staff while maintaining adequate staffing levels and budget compliance. The supervisor position contributes to staffing decisions such as hiring, coaching and counseling employees on work related performance. This position assists in the development and implementation of policies and procedures to ensure a safe and effective work environment. Other duties for the supervisor position include participating in performance improvement activities, as well as providing support for department management to achieve operational goals. This position may also perform staff duties and responsibilities as needed

Requirements:

PEOPLE ESSENTIAL FUNCTIONS
  • Participates in management responsibilities of selection, scheduling, supervision, retention, and evaluation of employees in the department. Provides development and mentoring of staff. Ensures that all department staff are properly trained and comply with all policies and procedures. Assists with meeting or exceeding threshold goal for department turnover.
  • Consults with department leadership on coaching/corrective counseling and staff performance to achieve desired outcomes. Conducts new hire feedback sessions and provides recognition/commendations, as appropriate.
  • Creates and maintains an environment of collaboration by role modeling teamwork within the department. Effectively interacts within and between departments ensuring seamless flow of information/communication. Role models clear and professional communication to facilitate problem resolution to achieve mutual understanding. Teaches others to critically think by verbally expressing rationale for decisions and follows up consistently.
  • Meets or exceeds threshold goal for department and/or system metrics on employee engagement indicators

SERVICE ESSENTIAL FUNCTIONS
  • Oversees daily department operations, schedule and activities. Sets priorities and functional standards, giving direction to staff as necessary to ensure the best possible delivery of service and high customer/patient satisfaction.
  • Organizes the workflow, proactively problem solves, anticipates needs, and manages multiple ongoing priorities. Provides reports to management of needs, issues to be addressed, and all important information necessary to ensure department success. Serves and actively participates on various committees as directed.
  • Generates and presents reports to accurately identify members and providers appropriate for chart review. Oversees coding reviews with department, coders, and physicians.
  • Coordinates with Managed Care to complete onboarding process for new physicians and departments. Provides continuous physician education as it relates to coding, charge capture and physician onboarding

QUALITY/SAFETY ESSENTIAL FUNCTIONS
  • Ensures a safe and effective working environment; assists in monitoring and/or revising the department safety plan and/or any specific accreditation/regulatory agency required safety guidelines.
  • Uses and optimizes information systems to enhance operations; participates in performance improvement and data management/analysis functions as directed.
  • Employs a proactive approach in the optimization of positive outcomes by monitoring and improving the department workflow, supporting peer-to-peer accountability, and identifying solutions via collaboration. Role models situational awareness, using teachable moments to improve safety. Participates in investigations as a result of the root cause analysis process as assigned by manager.
  • Monitors self and ensures employee compliance with policies, procedures, and System HR Standards of Practice and performs associated actions upon non-compliance (i.e., focal point review requirements, disaster plan, in services, influenza immunization, wage and hour, standard hours, timely termination submission, timely timecard approval, etc.)

FINANCE ESSENTIAL FUNCTIONS
  • Assists in the management of essential and non-essential department expenditures to achieve financial target through optimization of productivity, supply/resource efficiency, minimizing incidental overtime and overtime percentage, and other areas according to department specifications.
  • Manages staffing needs including scheduling, time off requests and time keeping.
  • Identifies, coordinates, and implements projects, programs, and procedures to improve the quality and cost-effectiveness of coding and charge capture operations.
  • Gathers and evaluates patient reimbursement data, analyzes results, and prepares reports. Investigates trends in reimbursement from identical codes and instances of low reimbursement

GROWTH/INNOVATION ESSENTIAL FUNCTIONS
  • Implements change, demonstrating the ability to motivate employees and follow through to ensure change in behavior has actually occurred. Supports Houston Methodist and department goals and vision. Identifies industry trends and implements innovative solutions for practice or workflow changes to improve department operations.
  • Develops skills of team members and continually assists with improving competencies, performance and outcomes. Fosters a positive and constructive teaching environment by engaging staff/team members in learning opportunities that are valuable and in alignment with business objectives. Conducts conversations with staff on their development and My Development Plan (MDP).
  • Seeks opportunities to identify self developmental needs and takes appropriate action. Ensures own career discussions occur with appropriate management. Completes and updates MDP on an on-going basis

This job description is not intended to be all-inclusive; the employee will also perform other reasonably related business/job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises.

Qualifications:

EDUCATION
  • Bachelor's degree in healthcare, business, accounting or related field

WORK EXPERIENCE
  • Five years of experience as a coding supervisor; for internal candidates, three years of certified coding experience or team lead experience, of which one year must have been in a role with progressive responsibility, preferably in a medical practice or professional billing department
  • Three years of auditing experience
LICENSES AND CERTIFICATIONS - REQUIRED
  • CPC - Certified Professional Coder (AAPC) OR
  • CCS - Certified Coding Specialist (AHIMA) OR
  • an approved Specialty Society Coding Certification

KNOWLEDGE, SKILLS, AND ABILITIES

  • Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations
  • Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security
  • Ability to effectively communicate through a variety of channels with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles; engages the recipient(s) and helps them understand and retain the message
  • Demonstrates the ability to interact with others in a way that gives them confidence in one's intentions and those of the organization
  • Demonstrates leadership qualities and critical thinking through self-direction initiative, effective interpersonal skills, and oral/written communication skills
  • Ability to identify and understand issues, problems and opportunities; and recommend solutions
  • Ability to work effectively in a fast paced environment
  • Demonstrates flexibility and adaptability in the workplace
  • Thorough understanding of managed care contracting, CPT/ICD-9/ICD-10 coding, third party and governmental payers, billing and compliance regulations, and computerized billing and collection management systems

SUPPLEMENTAL REQUIREMENTS

WORK ATTIRE

  • Uniform No
  • Scrubs No
  • Business professional Yes
  • Other (department approved) No

ON-CALL*
*Note that employees may be required to be on-call during emergencies (ie. DIsaster, Severe Weather Events, etc) regardless of selection below.

  • On Call* Yes

TRAVEL**
**Travel specifications may vary by department**

  • May require travel within the Houston Metropolitan area Yes
  • May require travel outside Houston Metropolitan area No

Company Profile:

Houston Methodist Specialty Physician Group is an integral part of Houston Methodist’s overall strategy to become one of the nation’s leading academic medical centers. Established as a nonprofit corporation certified by the Texas State Board of Medical Examiners, the Specialty Physician Group enables physicians to maintain autonomy with respect to clinical practice while growing their practice within an academic environment.

Houston Methodist is an Equal Opportunity Employer.

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