Responsible for the ongoing management of all Utilization Review Management staff related to all Payer Incentive Program processes for Temple Physicians Inc. (TPI). Oversees the daily responsibilities of each staff member by monitoring all work activities, productivity, and efficiency. Identifies and analyzes options for maximizing submission and quality by applying ICD-10 and payer specific guidelines, while also considering compliance with payer guidelines. Works with management on developing and continuing clinical documentation improvement processes and policies. Serves as a resource to clinical teams on aspects of medical record documentation required to support accurate severity of illness/medical complexity in accordance with the ICD-10 disease specific guidelines. Ensures all submissions are completed in the required timeframe and completion rates meet the budgeted targets. Assists with resolving issues and creating new processes. Provides training and counselling to staff and other interdepartmental team members as necessary. Conduct one on one education with providers and clinical staff when needed.
Education
Associates Degree (Required)
Bachelors Degree (Preferred)
Combination of relevant education and experience may be considered in lieu of degree.
Experience
5 Years experience in a Health Care setting with concentration in ICD- 10 coding and documentation review (Required)
License/Certifications
CERTCA - Certified Coding Associate (Required) or CCS - Certified Coding Specialist (Required) or CPC - Certified Professional Coder (Required)
CPMA - Cert Profess Medical Auditor (Preferred)
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Your Tomorrow is Here!
Temple Health is a dynamic network of outstanding hospitals, specialty centers, and physician practices that is advancing the fight against disease, pushing the boundaries of medical science, and educating future healthcare professionals. Temple Health consists of Temple University Hospital (TUH), Fox Chase Cancer Center, TUH-Jeanes Campus, TUH-Episcopal Campus, TUH-Northeastern Campus, Temple Physicians, Inc., and Temple Transport Team. Temple Health is proudly affiliated with the Lewis Katz School of Medicine at Temple University.
To support this mission, Temple Health is continuously recruiting top talent to join its diverse, 10,000 strong workforce that fosters a healthy, safe and productive environment for its patients, visitors, students and colleagues alike. At Temple Health, your tomorrow is here!
Equal Opportunity Employer/Veterans/Disabled
An Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.
Tomorrow is Here!
Temple Physicians Inc. brings the best together.
Our people enjoy something truly unique - settings with the resources of a world-class health system and the personal connections of a neighborhood doctor's office. With convenient locations, leading edge care, and staff who feel more like family, careers with Temple Physicians are second to none.
Do you enjoy getting to know patients in a professional setting? Appreciate the possibilities and support offered by a large health system? Then join Temple Physicians, Inc.