Manager, HIM Inpatient Coding Operations
- Direct management responsibility over all West Division inpatient coding.
- Oversight over all hospital based concurrent coders.
- Extensive knowledge of DRG and APR-DRG classification and reimbursement structures. Including IPF-PPS (Inpatient Psychiatric Facility Prospective Payment System) and IRF PPS (Inpatient Rehabilitation Facility Prospective Payment System).
- Responsible for 96% or better DRG/APR-DRG accuracy rate.
- Responsible for 93% or better moderate coding accuracy rate (C1).
- Responsible for scheduling coder work shifts and approving time off.
- Ensure that a provisional DRG is assigned within 24 hours of admission for all Inpatient accounts excluding Normal Newborn and Obstetrical Moms.
- Responsible to ensure coders are meeting productivity standards. Includes presenting a monthly report to the Executive Director, Health Information Management.
- Ensure that claim hold reason is assigned before account hits DNFB report.
- Ensure that second level review is completed on all PSI and Never Event cases.
- Maintain open communication with hospital leadership team including daily escalation of missing reports from providers.
- Trend and track coding queries issued by discharged coders.
- Ensure coding staff holds accounts until all medical content is collected before final billing.
- Promote a culture of collaboration between hospital leadership and shared service professionals.
- Coordinate workflow improvements with HIM Operations Management.
- Ability to develop, adhere to, and monitor policies and procedures for optimal revenue through coding that comply to all regulatory and compliance standards.
- Supports collaboration between remote Inpatient Coders, hospital based Concurrent Coders, and CDI.
- Abides by the Standards of Ethical coding set forth by AHIMA and monitors coding team.
- Present monthly status and goal report to Executive Director, Health Information Management.
- Maintain Discharged, but Not Final Billed goals set by Executive Director, Health Information Management.
- Ensure SHC policies related to HIM, Revenue Cycle, and Compliance are implemented and monitored.
- Implement HIM related projects at the direction of the Executive Director, Health Information Management.
- Support hospital based departments such as Quality, Risk Management, and Case Management with respect to HIM coding.
- Work with other SHC senior leaders as needed.
- Assists HIM Leadership team with development and implementation of health information management coding/CDI policies.
- Monitors changes in legislation and accreditation standards that affect health information management.
- Ensure that all coders have been awarded a professional AAPC or AHIMA coding credential. Prefer CCS.
- Education: Bachelor’s degree required
- Experience 10 years progressive HIM Coding Management experience within an Acute Care Hospital setting. Extensive experience with Revenue Cycle operations including acute care coding.
- Certification/Licensure: RHIA or RHIT with CCS
- Software/Hardware: Cerner and 3M 360 experience required
- Other: Required to work out of Steward Health Care office located in Richardson, Texas.
Travel: Expected travel is up to 10%. Education and/or company growth.
Job Status: Full Time
Job Reference #: 8358