Apr 10, 2024

Coding Director

  • Riverside Health System
  • Remote
Full Time (CPC) Certified Professional Coder

Job Description

Overview


Responsible for professional coding for physicians, advanced practice providers, and other qualified clinicians employed or contracted by Riverside Medical Group (RMG). Collaborates with physicians and advance practice providers, RMG leadership, practice directors and managers, revenue cycle leadership, and other key stakeholders regarding professional coding and documentation requirements and business processes.

Manages the RMG Coding team, which consists of coding managers, supervisors, and staff supporting a variety of specialties working in acute care, behavioral health, and outpatient practice settings. Plans, coordinates, monitors, and manages workflows ensuring effective and efficient daily operations of the department.

Provides leadership, strategic direction, oversight and coordination of the professional coding function to effectively and efficiently meet established goals and objectives.



What you will do

  • Providers leadership to direct and oversee the professional coding department, including staffing, hiring, disciplinary action, performance appraisals, recognition, training, and professional development to ensure effective and efficient daily operations of the department
  • Demonstrates professional and positive interpersonal relations dealing with internal and external customers. Partners with physicians and other providers to inform them of new coding conventions or changes in current coding conventions, and offer feedback on individual provider coding practices and clinical documentation.
  • Manages and monitors coding quality and staff productivity. Enforces operational, procedural, and regulator policies to ensure responsibilities are carried out in alignment with organizational philosophy, strategic goals, and directions.
  • Monitors timeliness of charge posting to ensure accurate and timely reporting of professional revenues
  • Monitors third party updates related to CPT codes, diagnosis codes, and related professional billing rules to ensure compliance with applicable rules and regulations on billing of professional services. Maintains coding expertise to support serving as a subject matter expert and liaison on professional coding across the organization to providers and stakeholders.
  • Solves problems, makes decisions, develops systems and processes for successful integration and implementation, utilizing organizational and analytical skills.
  • Provides leadership and guidance to managers, supervisors, and staff to ensure correct CPT and diagnosis code selection from clinical documentation, including, but not limited to, chart notes, abstracts from medical records documentation, medical diagnostic and/or interventional reports, and operative notes ensuring compliant coding selections are reported.
  • Reviews claim denials and rejections pertaining to coding and medical necessity issues and, when necessary, implements corrective action plans (such as educational programs) to prevent similar denials and rejections from recurring
  • Prepares annual coding department operating budget; monitors performance of actual results against budget to identify variances, implements corrective action plans as necessary to ensure adherence to annual budget.


Qualifications

Education

  • High School Diploma or GED, (Required) and experience may be considered in lieu of Bachelors Degree
  • Bachelors Degree, Business, Accounting or related field (preferred)


Experience

  • 7-10 years Recent relevant experience - professional coding (Required)
  • 3-4 years Supervisory experience (Required)


Skills and Abilities

  • Management level experience in a hospital or medical group setting with skills in professional billing and coding required.
  • Technical and professional knowledge and skills unique to the business and/or coding operations of a medical practice which may include but are not limited to financial, information systems, billing, coding, auditing, payer reimbursement, risk, and governance regulations.
  • Extensive knowledge of ICD-10, CPT and/or HCPCS, HCC.
  • Extensive knowledge and understanding of professional billing rules and regulations.
  • Experience with Medicare and private commercial insurance reimbursement.
  • Ability to identify problems and implement solutions for operational and process improvement.
  • Excellent communication and analytical skills.
  • Demonstrated ability to plan, manage, establish, and maintain a professional work environment.
  • Interpersonal skills necessary to direct subordinates and delegate tasks.


Licenses and Certifications

  • Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC) CPC Upon Hire(Required)
  • Certified Coding Specialist (CCS) - The American Health Information Management Association (AHIMA) CCS (Preferred)

Required Experience Level

Director Level

Minimum Education

High School

Minimum Experience Required

6-8 years

Required Travel

Less than 10%

Applicant Location

US residents only