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JOB SUMMARY
The Corporate Director of Health Information Management (HIM) and Coding is responsible for leading mid-revenue cycle HIM and Coding Operations. Functional assignments include managing all subsidiaries Medical Records departments, Coding Operations, Internal Coding and HIM Auditing, Health information and coding information system analysis and management, electronic data and optical imaging management, Release of information and Transcription services. Develops and implements plans to ensure the achievement of established objectives. Represents HIM, Coding and revenue cycle in meeting strategic objectives throughout the McLaren system. The director is expected to be a contributing member of the revenue cycle leadership team. Demonstrates the philosophy and core values of McLaren Health Care in the performance of duties.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES
1. Manages discharge not final Coding (DNFC) and discharge not final billed (DNFB) for the McLaren system.
2. Provides leadership throughout the system in regard to HIM, coding and other revenue cycle inquiries.
3. Works closely with the peers at the central business office to improve processes impacting the DNFB.
4. Strong knowledge of healthcare facility and professional claims processing including: ICD-10, CPT, HCPC, NDC codes and modifiers as well as thorough knowledge of UB and 1500 claim edits.
5. Working knowledge of Medicare, Medicaid, and third-party reimbursement methodologies.
6. Reads and interprets provider contracts to determine billing discrepancies.
7. Responsible for developing and outcomes of the monthly dashboard report for the revenue cycle.
8. Analyzes operation of system; prepares recommendation and documentation to create and update fiscal services and other related policies and procedures with respect to operating systems.
Qualifications:
Required:
Preferred:
Additional Information
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