Manager of Coding

Nature and Scope

This position creates and oversees all activities related to multi-facility inpatient and outpatient coding, rehabilitation, and Skilled Nursing coding; maintains a close working relationship with Revenue Integrity and Hospital Operations management to support coding accuracy that is consistent with industry standards and in compliance with the Official Guidelines for Coding and Reporting, including coordination with Clinical Documentation Specialists to ensure maximum MS-DRG reimbursement. This person is responsible for implementation of on-site and remote coding staff and support programs. This person will be accountable for developing/maintaining a culture of service, financial discipline and fiscal responsibility, compliance, ethics and integrity; and maintains knowledge of and assures departmental compliance with Principles of Responsibility, policies and procedures, applicable regulatory requirements and accreditation standards. This responsibility is expressed through monitoring, audits, reporting of findings and education to the appropriate parties. This person would oversee the reporting of prospective audit presentations to Leadership in conjunction with Coding and Performance plan. This would include reporting on denial management and A/R impacts. This position seeks to support the integrity of coding. This person assesses and maintains impact of current compliance activities and evaluates risk factors of coding and documentation practices; and uses understanding of interrelationships among systems across functional areas to redesign processes, improve efficiency, and ensure optimal results for the future.

Responsibilities

• Create and oversee all activities related to multi-facility inpatient and outpatient coding, rehabilitation, and Skilled Nursing coding.
• Maintain a close working relationship with Revenue Integrity and Hospital Operations management to support coding accuracy.
• Coordinate with Clinical Documentation Specialists to ensure maximum MS-DRG reimbursement.
• Implement on-site and remote coding staff and support programs.
• Develop/maintain a culture of service, financial discipline and fiscal responsibility, compliance, ethics and integrity.
• Maintain knowledge of and assure departmental compliance with Principles of Responsibility, policies and procedures, applicable regulatory requirements and accreditation standards.
• Oversee the reporting of prospective audit presentations to Leadership in conjunction with Coding and Performance plan.
• Report on denial management and A/R impacts.
• Support the integrity of coding.
• Assess and maintain impact of current compliance activities and evaluate risk factors of coding and documentation practices.
• Redesign processes, improve efficiency, and ensure optimal results for the future.
• Design and coordinate educational programs.
• Comply with state, federal and governing body regulations.
• Work cooperatively with other departments to achieve goals of the organization.
• Foster positive relationships between physicians, the community, and the organization with the purpose of maintaining cost-effective and high-quality documentation.
• Develop an education strategy highlighting the importance of the ICD-10 training program and how improved documentation will improve performance profiles and reimbursement.
• Develop and manage the Hospital Coding Trainee program to reduce the need for contracted coding staff and eventually be able to outsource our own coders to outside health care facilities.
• Develop and maintain orientation programs and in-services for staff development competency validation programs and rotations for coding trainees.

Requirements

• Education: Bachelors Degree from an accredited college is required or may substitute degree with years of experience on a year for year basis.
• Experience: Requires a minimum of 5 years ICD-10 and CPT coding management/leadership level experience.
• Certification: CCS or CPC is required. RHIA and/or RHIT preferred.
• Computer / Typing: Proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel, Teams, and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.