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Job Summary
Leads and manages the daily operations of Inpatient coding across multi-system facilities. Ensures accurate, timely and complete coding that reflects facility diagnoses and procedures for services provided in accordance with organization policies and procedures, coding guidelines, regulatory agencies and payer requirements. Collaborates with the Clinical Documentation team, Quality department and clinical providers to ensure optimal provider documentation for appropriate Diagnosis-related groups (DRG) assignment, Major Complications and Comorbidities/Complications and Comorbidities (MCC/CC) and Hospital Acquired Condition/Patient Safety Indicator (HAC/PSI) capture as appropriate through documentation validation. Collaborates with Health Information Management (HIM) and Clinical Documentation Improvement (CDI) on development of coder audit and education plans.
Essential Functions
- Manages, organizes and prioritizes work to ensure medical records are coded accurately and in timeframes that will assure compliance with regulatory, coding guidelines and payer requirements.
- Manage area human resources by, implementing and monitoring staffing plans, monitoring daily workload, providing direction through development plans and performance evaluations, managing projects and responsibilities in support of the department and organization vision, goals and standards of behavior.
- In partnership with Director of Coding, Clinical Documentation Integrity (CDI) Revenue Integrity and appropriate personnel, recommends and implements standardized, organized-wide coding guidelines and documentation requirements as well as collaborates to develop and implement training and educational programs for coders, CDI team members and clinical providers. –
- Assists in the development and implementation of coding policies, procedures and standard operating procedures.
- Continuously assesses and improves the department’s performance by designing operational processes, monitoring performance through data, implementing sustainable performance improvement.
- Manages and resolves customer concerns and coding discrepancies; identifies and implements mitigation strategies and takes a proactive approach to resolving issues and addressing complaints.
- Stays up to date with external policies and regulations that affect coding from agencies such as Office of Inspector General (OIG), Centers for Medicare and Medicaid Services (CMS) and other payers; communicates changes and impact on the coding teams.
- Participates in the design, testing and implementation of computer systems affecting coding and documentation.
- Performs other duties as assigned.
Supervisory/Management Responsibilities
- Job has direct and/or indirect supervision of team members that may include final budget authority, hire/termination authority, performance appraisal responsibility and disciplinary authority. Job will be considered a member of management staff at Prisma Health Company or affiliate and will have direct reports.
Minimum Requirements
- Education – Associate Degree in Health Information Management. Bachelor’s Degree in Health Information Management preferred.
- Experience – 5 years – Inpatient coding experience in acute care setting, three (3) years of which to include experience leading teams or progressive management in Health Information Management (HIM) Coding of a multi-entity healthcare delivery organization; experience with quality and clinical documentation integrity preferred.
In Lieu Of
Required Certifications, Registrations, Licenses
- Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), or other approved coding credential.
Knowledge, Skills and Abilities
- Strong knowledge of International Classification of Diseases-10 (ICD-10).
- Knowledge of Clinical Documentation Improvement principles, Quality Indicators, formal and informal coding audit processes.
- Ability to collect, maintain, analyze and report statistical and other data.
- Ability to work effectively, independently and manage multiple demands consistently.
- Ability to operate multiple Windows based software applications and experience with office software such as Excel and Word.
- Effective verbal and written communication and strong customer service skills.
- Excellent problem-solving and critical thinking skills.
- Knowledge of office equipment.
- Proficient computer skills (database).
Work Shift
Day (United States of America)
Location
Corporate
Facility
7001 Corporate
Department
70017512 HIM Coding
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