Job Description

  • Direct management responsibility over all West Division Outpatient coding. This includes Observation, Outpatient in a Bed, Outpatient Surgical, Routine Outpatient, Emergency department, and series accounts.
  • Extensive knowledge of APC classification and reimbursement structures.
  • Extensive knowledge in ICD-10-CM, CPT, and HCPCS coding.
  • Extensive knowledge of National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs).
  • Responsible for 96% Outpatient reimbursement accuracy. Includes proper assignment of APC, CPT, HCPCS, and modifier assignment.
  • Ensure Payer Billing Guidelines are followed and education provided to outpatient coding staff.
  • Responsible for scheduling coder work shifts and approving time off.
  • Responsible to ensure coders are meeting productivity standards. Includes presenting a monthly report to the Executive Director, Health Information Management.
  • Closely monitors DNFB accounts
  • Ensure that claim hold reason is assigned before account hits DNFB report.
  • Ensure that second level coding review and charge audit is completed on complex Interventional Radiology and Cardiac Cath lab accounts.
  • 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. This includes H&P’s, Operative Reports, Pathology Reports, etc.
  • 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.
  • 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.
  1. Education: Bachelor’s degree required
  2. Experience 10 years progressive HIM Coding Management experience within an Acute Care Hospital setting. Extensive experience with Revenue Cycle operations including acute care coding.
  3. Certification/Licensure: RHIA or RHIT with CCS
  4. Software/Hardware: Cerner and 3M 360 experience required
  5. Other: Required to work out of Steward Health Care office located in Richardson, Texas.

Travel: Expected travel is up to 10%.

Application Instructions

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