Director Medical Coding and Chart Audit Services HCS

Responsibilities

• Manage and oversee professional outpatient coding and chart auditing services.
• Facilitate medical documentation improvements for Catholic Health providers and Healthcare Solutions private clients.
• Manage and reduce coding denials.
• Aid in implementing EMR updates to improve documentation accuracy and reduce coding denial rates.
• Maintain and update claim scrubbers to ensure all coding edits are current and compliant with applicable federal and state regulations and CMS and AMA coding guidelines.
• Maintain coding education materials accurate and current based on coding guidelines and policies.
• Develop and maintain policies and procedures to improve and support overall quality of coding and auditing services.
• Maintain proper education, training, and quality audits for all practices/private clients and team members.
• Supervise manager coding and chart auditing services, professional medical coders, auditors, and coding vendors.
• Leverage project management skills, clinical knowledge, coding knowledge, and understanding of regulatory guidelines to continuously improve processes and compliance.
• Manage professional outpatient coding and chart auditing services for CHS providers and HCS private clients.

Requirements

• Bachelor's degree in a related health or science field.
• Medical Coding certification through American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA).
• Multiple certifications preferred.
• Thorough understanding of Current Procedural Terminology (CPT) codes, International Classification of Diseases (ICD-10) diagnosis codes, and appropriate modifier use.
• Experience with AHA Coding Clinic and CPT Assistant as resources.
• 3 - 5 years of multi-specialty professional coding experience required.
• Minimum 3 years professional experience as a coding and auditing manager in healthcare systems.
• Epic experience highly recommended.

Knowledge, Skill and Ability

• Extensive knowledge of Medicare and Commercial Payers coding and billing policies.
• Experience with NCCI edits, National and Local Coverage Determination Policies (NDC and LDC), and Medically Unlikely Edits (MUE).
• Experience working with EMR and practice management systems.
• Strong research capabilities with respect to medical procedures and technology.
• Excellent computer skills - Word, Excel, multiple EHR systems, and electronic encoders.
• Excellent communication skills.
• Works well in a team environment and can multi-task several responsibilities.
• Recognizes and protects the confidentiality of all patient and employee information according to HIPAA policy.
• Interfaces well with external and internal professionals at all levels - Medical, Legal, and Clerical.

Working Conditions

• Normal heat, light space, and safe working environment; typical of most office jobs.
• Long periods of sitting.