Job Description

About Us:

• Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, and now radiology, through the recent combining of forces with Advocate RCM. Focused on Revenue Cycle Management and Advisory services, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.

Job Summary:

• The Medical Supervisor, Coding Suspends plays a crucial role and must have a strong background in medical coding and billing, with expertise in identifying and resolving coding-related suspends. This position involves overseeing and leading a team of medical coding suspends specialists, responsible for reviewing and resolving coding-related suspends to ensure accurate and timely claim submission and reimbursement.

Essential Functions and Tasks:Team Leadership:

• Lead and manage a team of medical coding suspends specialists.
• Provide guidance, support, and mentorship to the team members.
• Foster a collaborative and positive work environment.
• Conduct regular team meetings to discuss updates, challenges, and training opportunities.

Quality Assurance:

• Develop and implement a comprehensive coding quality assurance program.
• Conduct super audits of medical coding suspends work to ensure accuracy and compliance with coding guidelines, regulations, and organizational policies.
• Provide constructive feedback to team members based on audit findings.
• Collaborate with coding educators to address training needs identified during audits.

Training and Development:

• Identify training needs for team members based on audit results and industry changes.
• Develop and deliver training sessions to improve coding proficiency and compliance.
• Keep the coding team updated on changes in coding guidelines, regulations, and industry best practices.

Documentation and Reporting:

• Document coding-related activities, findings, and resolutions in coding software or systems, maintaining accurate and complete records of coding-related suspends and resolutions.
• Communicate coding-related trends, issues, and best practices to coding and billing staff, providing education, training, and support as needed to improve coding accuracy and compliance.

Process Improvement:

• Collaborate with coding managers and other stakeholders to identify opportunities for process improvement.
• Implement strategies to enhance coding & billing accuracy, efficiency, and overall performance.

Communication and Collaboration:

• Assist with coding audits, reviews, and compliance initiatives, identifying coding errors, patterns, and opportunities for improvement.
• Participate in coding-related meetings, committees, and projects, contributing expertise and insights to support coding and billing operations.

Education and Experience Requirements:

• Bachelor\'s degree in any Life Science field.
• Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification.
• Minimum of 6 years of experience in medical coding/ coding suspends.

Knowledge, Skills, and Abilities:

• Previous experience in a leadership or supervisory role.
• Strong knowledge of ICD-10, CPT, and HCPCS coding systems.
• Familiarity with healthcare regulations, including HIPAA.
• Excellent communication, interpersonal, and organizational skills.
• Proficient in using coding software and electronic health record (EHR) systems.

Ventra Health, Inc.