Key Responsibilities
Oversees the daily operations of the Coding Unit.
Responsible for the development and implementation of systems to monitor the quality of coding
Recommends and implements changes to ensure data integrity and optimal reimbursement for services
Performs specialized and technical coding and performs data quality audits as needed
Assists with review of billing rejection audits and case-mix/billing department questions
Extensive knowledge of regulatory and compliance issues related to coding documentation and billing
Provides coding in service education and training in department and hospital as required
Provides on the job training, guidance to the coding staff
Principal Duties and Responsibilities
1. Supervises and organizes the daily operations of Coding Unit; including education and training.
2. Identifies impediments to efficient production and implements corrective measures as necessary.
3. Establishes and maintains systems and criterion to monitor the quality and effectiveness of coding practices ensure data integrity and optimal reimbursement for services.
4. Establishes and maintains working relationships with all hospital departments and affiliated groups in order to identify and address interdepartmental and interdisciplinary problems and issues. Obtains and coordinates resources, plans and facilitates implementation of programs and systems.
5. Participates in testing and evaluation of computer system enhancements and upgrades. Reviews and analyzes units information and automation needs and makes recommendations as appropriate.
6. Works with the billing department to resolve issues and responds to DRG validations audits/ reviews.
Minimum Knowledge and Skills required by the Job
Work requires the level of knowledge acquired through completion of a degree in Health Information Management or a degree in a closely related field with a minimum of 3 yrs supervisor experience
Knowledge of medical terminology, anatomy and physiology, pathophysiology, ICD-9-CM and CPT-4 coding classification systems, and regulatory agency requirements.
5+ years coding experience with specific experience in DRG Validation and/or compliance review in an acute care setting.
Work requires a working understanding of appropriate computer applications and software
Must be able to make decisions based on sound judgment and have the ability to prioritize own work and proceed with minimum supervision.
Strong interpersonal and written communication skills are required. Must be able to communicate both verbally and in writing in a highly professional manner
An excellent understanding of the DRG reimbursement systems is required.
Ability to work independently and as part of a team is critical. Proven analytical, investigative and organizational ability.
Certification, Registration, or Licensure required by the Job
RHIA, RHIT and/or CCS certification required
Qualified and interested individuals are encouraged to apply with a cover letter and resume at www.childrenshospital.jobs and refer to AutoReqId 20812BR.