HIM Coding Director

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Job Description Summary

Responsible for directing all centralized coding functions, including quality, productivity, coder training / education, physician onboarding / education and failed claims for the OhioHealth Network. Position also responsible for supporting Central Billing Office as necessary regarding Claims Processing issues as it relates to coding. This position is responsible for the development of coding guidelines in accordance with the most recent published regulations from CMS, AMA, ACOS, AHIMA, and the Official Coding Guidelines. They are accountable for the coordination of any new inpatient, outpatient or professional payment methodology impacting coding, abstracting, and hospital or professional reimbursement. The HIM Coding Director acts as liaison with other departments / practices to support coding of new services / practices. He / She will have operational responsibilities within Revenue Cycle and have interactive relationships with Sr. Leadership, physicians and providers throughout the network. He / she will work collaboratively with the VP Revenue Cycle to develop and deploy strategy that supports the mission, vision, and values of the organization.

Responsibilities And Duties :

• Coordinates and manages centralized coding and abstracting functions for the OhioHealth network and OhioHealth Physician Group. Oversees coding functions by establishing common guidelines / processes and updating these as clinical and financial processes change. Major goals include : accuracy of coded data, efficiency and productivity of coding team and integration of processes and guidelines at all sites to meet DNFB and A / R organizational financial targets.
• Provides guidance to the failed claims team who works internal failed claims and also works with departments regarding medical necessity issues to ensure documentation supports medical necessity. Problem-solves with departments to ensure processes are in place to address issues. Assists with processes requiring intervention as indicated throughout the billing / coding process. Ensures compliance with Revenue Cycle targets for resolution of failed claims.
• Coordinates billing / coding activities with Revenue Cycle and A / R representatives CBO, Patient Access, and Customer Service e and participates in problem-solving. Works with practice managers to ensure timely and accurate capture of all charges for coding and oversight of guideline for OPG practices.
• Monitors coder & physician audit results to maintain quality of information at all campuses / practices. Maintains current information on governmental regulation changes, especially ICD-9 CM, CPT-4 and HCPCS coding, and RVU, APC and DRG updates affecting coding, staffing, and hospital / professional reimbursement.
• Oversees HIM & OPG budget for coding operations $12.8 m. Conducts staff evaluations and disciplinary actions as necessary at all campus locations. Hires and / or fires any direct reporting positions.

Minimum Qualifications :

Bachelor's Degree (Required) CCS - Certified Coding Specialist - American Health Information Management Association, DNFB - Discharged Not Final Billed - State of Ohio, RHIA - Registered Health Information Administrator - American Health Information Management Association, RHIT - Registered Health Information Technician - American Health Information Management Association

Additional Job Description :

Health Services Administration or related field, and 5 years progressive management Experience with large multi-facility acute care coding operation and professional Experience, or 2 year technical program with 8 years progressive management Experience with large multi-facility acute care coding operation. Evidence of successful DNFB & A / R management. Certification in coding (RHIA, RHIT, CPT or CCS). Excellent communication, leadership, delegation, interpersonal and organizational skills. Strong problem-solving skills. Strong background in ICD-9-CM and CPT classification, DRG assignment and case mix analysis. Certification in coding. 8+ years in coding management in acute care hospital network.

Work Shift : Day

Scheduled Weekly Hours : 40

Department : Hospital Coding

Join us! ... if your passion is to work in a caring environment ... if you believe that learning is a life-long process ... if you strive for excellence and want to be among the best in the healthcare industry

Equal Employment Opportunity

OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment