Provides organizational leadership for clinical coding; leads daily activities and drives change to ensure accuracy and quality of clinical coding assignment across the system. Assuring accuracy and timeliness in coding of the medical record. Works with hospital leadership and medical staff to improve the overall quality and completeness of clinical documentation to accurately reflect patient acuity. The role serves as the translator from clinical to financial. Leads efforts to ensure accurate DRG based reimbursement is achieved and denials are reduced with improvements in data integrity.
JOB SPECIFIC RESPONSIBILITIES:
- Manages clinical coding team that includes coding and documentation compliance in regards to billing and educating providers on proper documentation to assure billing compliance with accurate payment.
- Oversees the direction, expenditures, policies, establishing best practices, managing staff and process for clinical coders. Coordinates with Clinical Documentation Improvement Team.
- Accountable for assuring accurate code and DRG assignment.
- Accountable for staff and provider training programs to ensure accurate coding and / DRG assignment.
- Provides subject matter expertise with ICD 9, ICD 10, CPT 4, and other classification systems.
- Oversees quality reviews.
3 to 5 years clinical coding experience required.
Two-year Associate's degree or equivalent experience required.
Four-year Bachelor's degree or equivalent experience preferred.
Specific Knowledge, Skills and Abilities:
- Maintain effectiveness when experiencing major changes in work responsibilities or environment; adjust effectively to work within new work structures, processes, requirements, or cultures.
- Use appropriate interpersonal styles to establish effective relationships with customers and internal partners; interact with others in a way that promotes openness and trust and gives them confidence in one's intentions.
- Meet patient and patient family needs; take responsibility for a patient's safety, satisfaction, and clinical outcomes; use appropriate interpersonal techniques to resolve difficult patient situations and regain patient confidence.
- Ensure that the customer perspective is a driving force behind business decisions and activities; craft and implement service practices that meet customers' and own organization's needs.
- Develop and use collaborative relationships to facilitate the accomplishment of work goals.
- Identify and understand issues, problems, and opportunities; compare data from different sources to draw conclusions; use effective approaches for choosing a course of action or developing appropriate solutions; take action that is consistent with available facts, constraints, and probable consequences.
- Provide feedback, instruction, and development guidance to help others excel in their current or future job responsibilities; plan and support the development of individual skills and abilities.
- Take prompt action to accomplish objectives; take action to achieve goals beyond what is required; be proactive.
- Deal effectively with others in an antagonistic situation; use appropriate interpersonal styles and methods to reduce tension or conflict between two or more people.
- Effectively manage one's time and resources to ensure that work is completed efficiently.
- Accomplish tasks by considering all areas involved, no matter how small; showing concern for all aspects of the job; accurately checking processes and tasks; being watchful over a period of time.
- Set high standards of performance for self and others; assume responsibility and accountability for successfully completing assignments or tasks.
- Assimilate and apply new job-related information in a timely manner.
- Clearly convey information and ideas through a variety of media to individuals or groups in a manner that engages the audience and helps them understand and retain the message.
LICENSES and CERTIFICATIONS:
Certification in Coding, Registered Health Information Administrator or Registered Health Information Technician required.
Sedentary - Exerting up to 10lbs. occasionally or negligible weights frequently; sitting most of the time.