Director of Coding, CDI & Revenue Integrity

New Yesterday

Position Summary: The Director of Coding, Clinical Documentation, and Revenue Integrity is responsible for planning, organizing and implementing all aspects of Coding, CDI and Revenue Integrity operations. The Director of Coding, CDI and Revenue Integrity will oversee Health Information Management. Ensure oversight of the organization processes, guidelines, Conway Medical Center policy and state/federal regulations. Provide leadership to promote effective and efficient review of physician documentation to support quality and the patient’s level of care and appropriate coding. Collaborates extensively with interdisciplinary teams including, but not limited to, physicians, clinical providers, Quality, Infection Control, Registration, Billing, Reimbursement and compliance to provide data and solution development processes. Effectively uses information technology and process design to efficiently direct workflow. Education: A bachelor’s degree in health information management or related field is preferred. Experience Minimum of fifteen (15) years in progressive Coding, CDI & Revenue Integrity Leadership experience in a hospital and physician medical group is required. Minimum of fifteen (15) years Management oversight of hospital coding operations and a diverse array of medical and surgical specialties required. Clinical proficiency necessary for oversight of the Clinical Documentation Specialists, strong leadership abilities, and excellent critical thinking skills. Effective communication skills and excellent working relationships with physicians. Licensure/Certification/Registration AAPC Certification is required. Lead and manage the Coding, CDI, and Revenue Integrity department, ensuring compliance with established policies, procedures, and regulatory requirements. Demonstrates a thorough understanding of the MS-DRG system, CC's and MCC's impact on Quality and CMI as well as ICD-10 coding systems and guidelines related to coding and clinical documentation improvement. Directs, manages and oversees the clinical documentation program, identifying areas of focus for improvement opportunity through report analysis interpretation of process and operational reports, financial and compliance reports and quality ratings. Coordinates follow up on unanswered queries as needed to obtain prompt response to open queries. Oversee second level chart/coding review processes to ensure appropriate documentation to support PSI/HAC diagnosis, most appropriate principal diagnosis, DRG and POA assignment and completeness of all supporting documentation. Serves as a resource to physicians and administration regarding issues related to the appropriateness of coding, revenue integrity and clinical documentation. Responsible for charge description master systems, revenue charge capture, HCPCS, coding and reimbursement for the organization. Works collaboratively with the team to facilitate documentation within the record that supports patient's severity of illness and risk of mortality utilizing strong communication skills and follow up. Provide senior leadership financial reports including staffing productivity, revenue recognition, audit analysis, compliance and other metrics. Implement policies, processes, controls, audit and compliance plans coordinating with billing, revenue integrity, hospital coding department, office personnel, physicians and CIS. All compliance plans and internal controls will follow federal, state, and industry guidelines. Incorporates quality and productivity standards and monitor staff performance against established standards. Ensures that staff collect, assign, and sequence codes for diseases, operations, newborns, and complications for inpatients and outpatients, as well as link appropriate medical necessities to services. Develop and maintain fiscal oversight for department operating expenses, including analyzing monthly expenses, providing monthly variance analysis, approving expenses within authorized limits, and annual operating budget preparation. Develop and implement a staff development program that provides continuing education and professional growth for the coding staff. Ensure current books, periodicals, CD's, websites and other reference material are available within the coding department. Participation as a member of the Conway Medical Center operations and hospital coding leadership team and division strategic planning process. Directs and leads strategic coding initiatives. Assists with coordination of department performance excellence activities. Act as a liaison with internal personnel/departments and outside agencies on coding and billing related issues. Represent the organization in coding related claims disputes and external audits. Responsible for department workflow and redesign for continual improvement of quality and productivity. Responsible for the timely implementation of all coding-related software program updates necessary with coding system revisions. Prepare periodic data reports from coding and abstracted data as requested. Complies with established corporate and departmental policies, procedures, objectives, quality assurance methods, and safety codes. Demonstrates compliance with licensing, regulatory and accrediting agency provisions as required. Supports departmental and organizational mission through appropriate use of resources, aiding team members, accepting work or schedule assignments, participating in process/ performance improvement activities as required. Participates in Conway Medical Center committees and meetings as required.
Location:
Conway
Job Type:
FullTime