Coding specialist serp_jobs.h1.location_city

Our client, a world-class, patient-centered, integrated, academic medical center, and one of the nation's premier centers for excellence in clinical care, biomedical research and medical education, is hiring a Health Information Management Director - HIM.  The Health Information Management Director - HIM is responsible for overseeing all aspects of medical coding operations for the hospital ensuring accurate, timely, and compliant coding for inpatient, outpatient, and specialty services including Emergency Department, oncology, research and other ancillary services.  This role involves managing the coding team, ensuring adherence to federal, state, and payer regulations, and driving initiatives to improve coding quality and efficiency. The HIM Director will collaborate with key stakeholders, including clinical departments, revenue cycle teams, and leadership, to optimize coding processes that support both clinical and financial objectives of the academic medical center. This is a hybrid position.

Responsibilities :

Lead and manage the medical coding team, providing guidance, support, and professional development opportunities.

Establish coding performance metrics, monitor team performance, and implement strategies for continuous improvement.

Ensure adequate staffing levels, training, and certification requirements for coding professionals.

Foster a collaborative environment between the coding team and other departments, including clinical, compliance, and revenue cycle teams, with a strong partnership with Clinical Documentation Integrity (CDI).

Ensure compliance with ICD-10, CPT-4, HCPCS, and other applicable coding standards.

Maintain knowledge of federal, state, and payer regulations to ensure coding practices are aligned with evolving healthcare standards.

Conduct periodic audits to assess coding accuracy and resolve any discrepancies.

Oversee the implementation of coding updates, including ICD-10-CM / PCS, CPT-4, and HCPCS, ensuring the team is trained on changes.

Work closely with billing, reimbursement, and coding teams to optimize the revenue cycle process and maximize reimbursement.

Identify coding and billing patterns, providing feedback and recommendations for process improvements.

Ensure timely coding of all records to maintain acceptable unbilled numbers to promote healthy cash flow patterns.

Collaborate with clinical departments and leadership to ensure coding practices are aligned with clinical documentation.

Develop and deliver ongoing training programs to coding staff to keep them updated on changes in coding guidelines, regulations, and payer requirements.

Work with clinical staff to improve clinical documentation practices to support accurate coding and reimbursement.

Serve as a expert resource for coding-related queries and provide expertise on complex coding scenarios.

Analyze coding data to identify trends, opportunities for improvement, and potential risk areas.

Prepare and present regular reports on coding accuracy, compliance, and productivity to senior leadership.

Collaborate with data analysts and IT teams to implement coding and revenue cycle reporting tools.

Strategically plans for long term goals include resource allotment / savings and technology use.

Foster strong working relationships with the clinical community to support initiatives and the integration of coding processes within clinical practice.

Provide guidance on coding for clinical trials, academic projects, and specialty care services.

Promote positive public relations for the department and health system.  Minimum Qualifications :

Bachelor’s degree in Health Information Management (HIM), Healthcare Administration, or a related field with Registered Health Information Administrator (RHIA)

Certified Coding Specialist (CCS) certification OR Registered Health Information Technician (RHIT) certification

Certified Coding Specialist (CCS) certification

Minimum 12 years of progressive experience in medical coding, including at least 7-10 years in a leadership role at an academic medical center or large healthcare system.

Knowledge of regulatory requirements and payer-specific coding guidelines (Medicare, Medicaid, commercial insurers).

Knowledge of federal, state and payer reimbursement methods, Diagnosis-Related Groups (DRGs) and severity systems as well as universal coding practices and guidelines.

Possesses a high level of clinical knowledge to participate collaboratively with clinicians.

Must have strong critical thinking, data, financial and analytical skills, as well as an exceptional ability to integrate clinical, coding and reimbursement knowledge.

Must be able to recognize payer and DRG differences / implications in hospital financial / reimbursement.

Must be highly detail oriented, have strong organizational skills, and possess excellent communication, presentation and interpersonal skills.

Computer proficiency (MS Outlook Office, Excel, PowerPoint) is required. Preferred Qualifications

Master’s Degree in HIM or related field with RHIA + CCS.

Certifications from AHIMA, ACDIS, AAPC and other professional organizations are also encouraged.

Proficiency with Epic EHR, 3M / Solventum tools and analytical knowledge in Tableau and Vizient. Salary : The posted range is not a guarantee. The actual salary will be based on qualifications, experience, and education and could fall outside of this range. Contact us for more information.

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