Director-Health Information Management/Coding

US
4 weeks ago
Position Code
296
Status
Regular Full-Time
Department
MG CBO Coding

Overview and Responsibilities

Responsible for directing coding quality processes for Baptist to ensure compliance with coding guidelines and regulations. Evaluates coding practices and determining baselines; planning, designing and implementing coding monitoring activities. Provides continuing education and training to revenue cycle staff, including coding, billing, office and HIM staff. Works collaboratively with BOC team to ensure appropriate use and build of system.

Directly manages quality audit and education staff involved in medical records coding /abstracting, provides direction for all physician and hospital coding activities, reviews, education, and productivity standards required to reach unbilled targets at all offices.   Thorough knowledge of clinical coding & reimbursement topics and experience with electronic medical records required. Project management and advance software skills a must. Performs duties as necessary to support quality improvement process in the coding/revenue charge capture department, as well as that of the physician groups, as well as any hospital side coding that may fall under the departments’ jurisdiction. Must have strong written and speaking skills as well as good verbal presentation ability.  Position supports hospital and professional coding, education and revenue cycle.

 

Principle Duties and Responsibilities:

  1. Manages a support coding staff to ensure coding accuracy, completeness and timeliness is accomplished in all Baptist entities.

 

  1. Develops and manages an internal program for maintaining compliance with coding guidelines and regulations.
  2.  
  1. Provides training, continuing education, resources and updates to all Baptist medical and coding staff in coding, documentation requirements, and reimbursement issues.
  2.  
  1. Performs internal coding and documentation audits and prepares and presents related reports.
  2.  
  1. Works collaboratively with HIM Department Directors, physician offices, and others in developing/enhancing uniform coding policies and procedures in accordance with coding guidelines and regulations.
  2.  
  1. Identifies training opportunities, with design, development, scheduling, and implementation of those activities as needs are identified.
  2.  
  1. Provides consultation and leadership throughout Baptist relative to coding inquiries and/or problem resolution.
  2.  
  1. Assists Director, Coding to eliminate all holds on all accounts utilizing appropriate software.
  2.  
  1. Develops and implements policies, procedures, and guidelines to assure clear and consistent operation of coding areas while encompassing departmental and organizational needs, in close collaboration with BMG leadership, physicians and Director, Coding.
  2.  
  1. Participates in internal and external compliance audits, including insurance and RACs.
  2.  
  1. Performs all management functions, including interviewing, hiring, training, evaluating, and disciplining for all direct reports.
  2.  
  1. Demonstrates competency in the use of Epic software, as well as all computer applications in area of responsibility.
  2.  
  1. Assigns and schedules the work of direct reports and manages to insure a smooth and efficient workflow. Identifies opportunities for efficiencies, reviews, and implements as approved.
  2.  
  1. Participates in the development and implementation of market goals, policies, procedures and budget.
  2.  
  1. Remains abreast of all developments in the coding field, especially as they apply to coding, reimbursement, and clinical database developments/changes.
  2.  
  1. Maintains all assurance and improvement activities for managed functions.
  2.  
  1. Establishes, maintains and updates job descriptions, job standards, and procedures for supervised areas.
  2.  
  1. Presents appropriate coding and documentation issues for both professional and hospital coding to the correct committee, as appropriate.
  2.  
  1. Acts as a system liaison for both hospital and professional coding.
  2.  
  1. Works with compliance for review and oversight of documentation issues, as needed.
  2.  
  1. Oversight, planning, and development of coding audit team.
  2.  
  1. Participates in reviews of offices from a coding and HIM perspective in the due diligence process of acquisitions.
  2.  
  1. Additional Responsibilities/Performs other related duties as assigned.
  2.  

Qualifications

Special Skills and Abilities Required

  1. The analytical abilities necessary to formulate policies and procedures, prepare various reports and records, assists in the development of department budgets.

 

  1. The interpersonal skills necessary to interact with all levels of department personnel, other departments, physicians and individuals from outside Baptist.

 

Responsibilities/Qualifications:

  1.       Level of knowledge equivalent to Bachelor’s Degree in Health Information Management Administration, with certification as a Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), or Certified Professional Coder (CPC). (If individual has only CPC, proven experience in hospital coding must be proven.) Individual should have background in both physician and hospital coding and HIM functions.

 

  1. 8+ years of progressive coding auditing, review and education experience, including ICD-9/10, CPT, HCPCS, DRG, and APC methodology. Physician and hospital coding experience required. Minimum of 3 years of supervisory experience.

 

  1. Epic experience not required but highly desired.

 

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