Director, Professional Coding & Education

Position: Director, Professional Coding Operations & Education

Department: HIM/ Revenue Cycle

Schedule: Full Time

POSITION SUMMARY:

The Director of Professional Coding and Education is responsible for providing coding oversight and creating standards to ensure coding accuracy, compliance and appropriate reimbursement across BUMG, along with managing operational execution of these standards in areas reporting to Revenue Cycle. The Director has responsibility for managing coding operations and overall success of an effective program, including oversight for coding training across BUMG. The Director manages coding staff to ensure compliance with coding guidelines, regulatory agencies and that appropriate reimbursement is received for the level of service rendered. The Director is responsible for a diverse, growing department, requiring skills in data-driven decision-making, project and portfolio management, system redesign, process improvement/lean management, and customer relationship management. This position requires a deep knowledge of industry best practices in technology and workflow. The Director will use these skills and experience to partner with physicians, department chairs, department administrators, and other clinical and non-clinical operational stakeholders in a highly complex and decentralized professional coding model, to develop an organization-level roadmap of process and technology improvements to maximize patient and provider experience from a coding perspective, while increasing efficiency.

JOB REQUIREMENTS

EDUCATION:

Minimum: Bachelor's Degree in a health-related field. Four (4) years of relevant experience may be considered in lieu of degree in addition to the experience below.

Preferred: Bachelor's Degree in Health Information Management

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

Minimum: Certified Professional Coder (CPC) or Certified Coding Specialist Professional CCS-P)

Preferred: RHIT, RHIA

EXPERIENCE:

Minimum: of 4 years related experience in professional coding with ICD-9/ICD-10, E/M and CPT. 3 years management experience in Medical Coding medium or large health care facility.

Preferred: 3 years management experience with an academic medical center

KNOWLEDGE AND SKILLS:

• Expertise knowledge of ICD-9/ICD-10, CPT and E&M coding principals and guidelines
• Knowledge of MS, AP, and APR DRG systems APG, EAPGs
• Knowledge of payer reimbursement methodologies, federal, state and payer specific regulations, policies and compliance standards
• Excellent written verbal and communication skills
• Excellent critical thinking skills
• Excellent skill in providing hands-on education to providers including audit finding and improvement opportunities.
• Excellent organizational skills, including ability to multi-task, prioritize essential tasks, follow-through and meet timelines.
• Ability to work cooperatively with members of the healthcare delivery team and staff,
• Ability to adapt to changes in workload and priorities, responding quickly to urgent requests.
• Ability to mentor, guide and motivate direct reports through demonstration of best practices and leading by example.
• Excellent communication and interpersonal skills to include the ability to negotiate and resolve conflicts and build teams.
• Demonstrated creativity and flexibility.
• Ability to operate in high-pressure situations.
• Excellent organizational skills.
• Demonstrated innovative approach to problem resolution.
• Ability to work collaboratively across BMCHS entities and disciplines.
• Demonstrated commitment to patient- and family centered care.
• Broad knowledge of modern health care administration practices and principles within a managed care environment and/or an academic medical center.
• Effective analytical ability in order to develop and analyze options, recommend solutions to and solve complex problems and issues.
• Demonstrated effective managerial and administrative leadership of clinical operations
• Knowledge of principles and techniques used in negotiation as applied to service contracts and equipment purchasing.
• Effective organizational, planning and project management abilities.
• Experience in financial and programmatic presentations.
• Ability to function independently and deal with multiple, simultaneous projects.

ESSENTIAL RESPONSIBILITIES / DUTIES:

Administrative Leader

• Contribute to the success of BMCHS by providing leadership, direction and coordination of operations, finances, and human resources for Professional Coding
• Manage and direct all Professional Coding activities within areas of responsibility.
• Continually assesses all services, identifies problems, utilizes data to analyze and propose innovative approaches for solutions.
• Maintain records related to operations and services that are complete, accurate, available, and in compliance with all legal, regulatory, and policy requirements.
• Engages staff and other stakeholders in continuous improvement of systems and processes; manages resources for staff participation in improvement work activities.
• Ensures effective facilitation of improvement teams and development of leadership skills to ensure overall effectiveness of the meetings.
• Organizes and prioritizes time and resources to manage efficiency and appropriately delegates.
• Remains current of new trends and best practices and incorporates into Professional Coding practices and programs.
• Articulates and enforces standards for quality/productivity
• Identify trends in documentation and coding concerns and collaborate with Leadership and Compliance to assess and implement corrective action
• Demonstrates achievable and measurable results and develop action plans for improvement
• Initiates, monitors, and enforces regulatory requirements
• Holds self and others accountable to policy, standards and commitments and provides timely follow through on questions and concerns.
• Ensures development Professional Coding initiatives to improve patient satisfaction and family centered care.
• Develops and implements clinical outcome measures for quality improvement * Incorporates the use of evidence-based practice and appreciative enquiry into program development and improvement activities
• Actively listens to staff ideas and concerns, assesses others communication styles and adapts to them.
• Effectively facilitates meetings within Coding, CDI, and Revenue Cycle Operations and organizational level.
• Creates bi-directional systems that effectively communicate information and data, utilizing multiple methods.
• Articulates and presents data, information, and ideas in a clear and concise manner.
• Participate in rejections, denials and claims review process with billing team to ensure compliance and accurate reimbursement
• Communicates with physicians, academic department leaders, and senior administrators to maintain coordination with BMCHS programs.
• Demonstrates empathy and concern while ensuring goals are met.
• Manages the complex interdepartmental and interdisciplinary relationships to assure collaboration and effective/efficient operations within Coding and Revenue Cycle.
• Creates an environment that encourages diverse opinion, recognizes differences, and incorporates into process and services.
• Exhibits awareness of personal attitudes and beliefs, recognizing its effect on response to others.
• Creates a culture and systems for recognizing and rewarding staff

Resource Manager

• Creates and maintains a satisfying workplace that fosters professional growth and job satisfaction for all members of the healthcare team.
• Interviews to select top talent, matching Professional Coding Operations needs with appropriate skill sets.
• Develops and implements recruitment and retention strategies that support a culture of leadership.
• Identifies and addresses own professional growth needs.
• Assesses manager and staff development needs, identifies goals and provides resources.
• Identifies lack of competency in performance and establishes a plan which includes goals, interventions, and measures.
• Maintains membership in professional organization(s) to develop knowledge and resources through networking, continuing education, and participation in national, regional, and/or local activities.
• Ensures integration of ethical standards and core values into everyday work activities.

Educator/Research Facilitator

• Facilitate accurate representation ofprofessional coding and clinical documentation through interaction with physicians, coders and practice staff by providing ongoing education
• Contributes to a learning environment by providing educational opportunities to staff, cross-functional departments, students, residents, fellows, and faculty.

Critical Interfaces

• Leads and/or serves on a variety of appropriate internal and external committees to represent the Professional Coding

Departmental Leader

• Must adhere to all of BMC's RESPECT behavioral standards.
• Interprets impact of broad scope organizational change for staff and develops change strategies for successful implementation.
• Models Respect for People commitments through all interactions.
• Leverages Leadership Competencies to develop themselves and others
• Develops and manages operational initiatives with measurable outcomes.
• Formulates objectives, goals and strategies collaboratively with other stakeholders.
• Prepares and delivers reports to operational leadership outlining progress toward meeting annual goals and objectives, to include performance related to finance, clinical activity, quality, and human resources. IND123

Equal Opportunity Employer/Disabled/Veterans