Job Details

JOB SUMMARY

Manages the Coding Section of Health Information Management (HIM) and functions as a resource and facilitator for all areas of hospital coding operations. Assures compliance with CMS, AMA and AHIMA standards for ethical coding, The Joint Commission Standards, Medical Staff Bylaws, Rules and Regulations, State and Federal Guidelines and department/organizational policies and procedures.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

• Plans, organizes, and supervises the work and systems of one or more of the following Health Information Management programs:
  • In Patient, Observation, Day Surgery, Emergency Department and Outpatient Coding
  • Post discharge physician queries
  • 3M Encoder processes
  • Coding Compliance Plan
  • Dissemination of coding changes and updates
  • Identification of coder educational needs through continual monitoring and auditing of coder accuracy
• Continual monitoring of charts not final coded. Establish DNFC targets by patient type and coder.
• Monitor and report individual coder productivity. Coach and counsel under performers.
• Assignment and reassignment of un-coded charts to specific coders as necessary to better manage the DNFC.
• Evaluate individual coder accuracy through focused audits. Identify education needs to facilitate coding accuracy improvement.
• Review all DRG reclassifications before and after assigning correction to the coder who completed the original coding. Track and trend patterns by payer, coder, MS-DRG and physician.
• Monitor the coding compliance manual. Monitor industry publications and implement changes as necessary.
• Gives input regarding section needs in preparation of annual budget and monitors expenditures for budget compliance.
• Attend meetings within and outside the facility as needed or requested to provide input and act as a coding information resource.

FINANCIAL RESPONSIBILITY

• Provides input regarding departmental budget specific to area of responsibility.
• Directly impacts days not final billed (DNFB), overall A/R and monthly revenue collection.

SUPERVISORY RESPONSIBILITIES

This position carries out supervisory responsibilities in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

KNOWLEDGE, SKILLS, ABILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Computer training: HBOC Star; 3M Coding & Reimbursement software; SoftMed Systems; MS OFFICE; Horizon Patient Folder; Groupwise; DVI Dictation System; External Transcription Agency Systems
• Extensive knowledge of medical record documentation requirements mandated by Medical Staff Bylaws, Rules and Regulations
• State and federal regulations regarding patient confidentiality
• Excellent verbal/written communication and interpersonal skills
• Thorough/detailed knowledge of ICD-10-CM, ICD-10-PCS and CPT coding systems
• Skilled in formulating and writing statistical reports
• Skilled in performing quality assessment/analysis
• Must display strong interpersonal skills
• Works collaboratively with CDI, quality, and other facility leaders

EDUCATION / EXPERIENCE

• Associate Degree in Health Science Administration/HIM Technology, minimum
• Bachelor's degree, preferred
• Registered Health Information Technician (RHIT) certification
• Registered Health Information Administrator (RHIA) certification
• Minimum three years supervision of coding staff, required
• Five years of progressive management experience

CERTIFICATES, LICENSES, REGISTRATIONS

• Required: RHIA, RHIT, CCS, CCA, CCS-P, and/or CPC-H

PHYSICAL DEMANDS

• Duties may require bending, twisting and lifting of materials up to 25 lbs.
• Duties may require driving an automobile to off- site locations.
• Ability to sit for extended periods of time.

WORK ENVIRONMENT

• Work environment is at a moderate noise level.
• Capacity to work independently in a virtual office setting or at hospital setting if required to travel for assignment.
• Works in a private office space in the coder's home per conifer Telecommuter Policy as defined in the Telecommuting Program Guide

OTHER

• Duties may require travel via, plane, care, train, bus, and taxicab.

Conifer Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability, or protected veteran status.