Role and Responsibilities
The Director of Coding is a certified subject matter expert in medical coding. The Director will provide leadership to create and enhance current processes and ensure operational standardization, efficiency, accuracy, compliance and productivity. This position will oversee the coding and audit functions for all corporate locations. The Director of Coding reports to the VP of Coding Services and Operations.
- Responsible for establishing productivity/performance benchmarks by specialty/across systems while ensuring quality outputs for the operating centers and clients, and continually analyzing, improving and implementing systems and processes that impact coding.
- Maintain deficiency reporting and feedback loop to local operations management, client management, and providers as appropriate.
- Work with operations and client management in understanding root causes for coding-related claim denials (physician documentation, coder error, system error, etc.).
- Proactively and reactively research, analyze, and resolve coding and compliance issues to optimize reimbursement and minimize audit liability.
- Analyze coding patterns of physicians to identify potential compliance risks, recommend solutions, and monitor improvements.
- Conduct and/or oversee all client coding education or in-servicing to ensure standard messages to clients.
- Communicate coding and compliance changes to physicians and staff.
- Manage coding workflow, productivity, and performance; assists with coder hiring and orientation; coordinates staffing for adequate coverage, including contract or third-party coverage as appropriate.
- Responsible for implementing and maintaining equitable workflow practices between the locations and establishing reporting processes which provides visibility to unit leaders on work status. Communicate workflow status and other productivity reports to management.
- Develop and execute annual education plan for coding departments, including maintaining certification requirements and other requirements set forth by clients.
- Ensure compliance with internal processes and procedures, state and federal mandated regulations. Coordinate activities, documentation and responses to outside coding reviews.
- Work cooperatively with compliance, client management and operations on external third-party audits. Assist with review of findings and communication to internal company and to clients.
- Represent coding department during client meetings and company meetings as requested.
- Work with operations and IT to understand and leverage coding tools and technologies in the workplace.
- Support the sales team in obtaining RCM and coding-only contracts.
- Work with the global team on coding process workflow and provide coding expertise to the global team.
- In conjunction with the VP of Coding, develop an annual budget and written justifications for capital and operational budgets. Responsible for monitoring and justifying budget variances on a monthly and quarterly basis.
- Must be able to work in a fast-pace environment.
- Must be able to travel to various locations and clients as needed.
- Must have the ability to clearly communicate verbally, in person, and in writing with physicians and other members of the team.
- Must be able to work rapidly, make sound decisions within limited time elements, and carry out responsibilities in a professional manner at all times, as well as have the ability to work cooperatively, effectively with other staff on an individual and team basis.
Education and Experience:
- 5 to 7 years progressive management experience in physician medical coding.
- Experience should also demonstrate expert level knowledge of CPT/ICD10, third party reimbursement guidelines and methodologies, effective written and oral communication skills, highly effective management and team-building skills, and demonstrated commitment to quality improvement.
- Must have the ability to analyze and interpret data, and good problem-solving skills and initiative.
- Must have experience in conducting coding audits and reviews.
- Bachelor’s degree in Healthcare Administration, Business Administration, Nursing, Finance or related field preferable.
- CPC or RHIT Certification(s) required.
- Prolonged periods sitting at a desk and working on a computer
- Must be able to lift up to 15 pounds