PRN Clinical Coding Reimbursement Compliance Manager

Job Summary

Working with the Vice President/Deputy Compliance Officer and Director Compliance and Audit for Corporate Compliance, this position is responsible for developing, implementing and maintaining a data quality compliance plan for hospital inpatient/outpatient coding and reimbursement. The person in this position is responsible for development of standards, policies, and procedures as well as education and training programs regarding elements of the HIM coding compliance. This includes documentation and accurate coding to all appropriate personnel, including HIM coding staff, physicians, billing personnel and ancillary departments. This person will also coordinate and conduct review of targeted areas to assume timely billing process, correct hospital reimbursements and perform random audits to validate accuracy of DRG, APC, and other coding to ensure compliance with coding and billing requirements.

Minimum Qualifications

• Degrees / Work Experience / School Education: Bachelor's Degree (And) Five (5) Years Work Experience coding management experience in a large acute care hospital setting.

• (Or) High School Diploma or GED (And) Nine (9) years work experience coding management experience in a large acute care hospital setting.

• Licenses & Certifications: Certified Coding Specialist (or) CCS-P from AHIMA, Certified Inpatient Coder (CIC)

• Management Experience: Five (5) years management experience

• Communication Skills: Exceptional Verbal (e.g., Public Speaking)

• Proficiencies: MS Access, MS Excel, MS Word, P.C.

Job Attributes

• Work Schedule: Eligible for Telecommute

• Other Requirements:

• Must have a strong background in ICD-10-CM Classification systems, knowledge of anatomy and physiology, clinical medical and medical terminology, along with excellent working and current knowledge of federal and the All-Payer DRG reimbursement methodology for hospital (facility) billing.