Director of Coding

Responsibilities

• Operational Leadership: Direct all coding activities for hospital inpatient, outpatient, and professional fee services
• Monitor and manage Discharged Not Final Billed (DNFB) and Candidate for Bill (CFB) targets to ensure optimized cash flow
• Standardize coding workflows across the health system to ensure consistency between facility and professional service reporting
• Work with various leaders and providers to ensure optimal revenue attainment and complete compliance with governmental and private payer requirements
• Responsible for working with Compliance Officers and UPH Internal Audit to ensure all aspects of Coding Compliance and Coding Audits meet the overall UnityPoint Health Compliance Plan
• Maintains compliance with Medicare, Medicaid, and other payer coding guidelines
• Lead, mentor and evaluate internal team of coding managers and staff
• Vendor & Relationship Management: Develop and maintain strong, collaborative relationships with outsource vendors
• Oversee the management of service level agreements (SLAs), ensuring performance metrics are clearly defined, tracked and consistently met or exceeded
• Compliance & Quality Assurance: Collaborate with the Coding Quality department to ensure internal and vendor compliance with CMS, OIG, and HIPAA regulations
• Ensure accurate assignment of ICD-10-CM/PCS, CPT, and HCPCS codes, as well as MS-DRG and APR-DRG validation
• Collaborate with the Clinical Documentation Improvement (CDI) team to bridge gaps between documentation and coding

Qualifications

• Education: Required: Bachelor's Degree in Health Information Management Preferred: Master's Degree in Health Information Management, Healthcare Administration, or Business Administration
• Experience: Required: 3-5 years direct experience with hospital coding, reimbursement methodologies and leadership experience Required: 7-10 years of experience in managing effective coding operations
• Licenses & Certifications: Required: RHIA, RHIT, CCS, CCS-P, CPC or equivalent coding credentialed
• Knowledge, Skills, & Abilities: Thorough knowledge regarding MS-DRG’s, APC’s, ICD-10, CPT, HCPCS coding principals, coding all patient types and official coding guidelines Comprehensive knowledge of billing coding requirements Strong analytical, communication, and executive reporting skill Knowledge of compliance rules and regulations Knowledge of quality metrics and commitment to enforcement of standards Ability to work independently in a fast-paced environment