Position Summary:

Under the leadership of the Vice President/CFO, the Director of Coding and Revenue is an active member of the Financial Services team that delivers professional financial services and support that is consistent with the strategic vision, goals, philosophy and direction of Financial Services and CRHS.The Director is responsible for directing, supporting, monitoring and coordinating coding and abstracting processes for all professional and Physician services. The Director is primarily responsible for ensuring the completion, accuracy and compliance of all the coding functions, which may include but are not limited to, promoting a positive and productive work environment, tailoring and/or creating coding policies and procedures and developing process improvement initiatives. . The ideal candidate will have experience in physician practice billing, coding and process development/improvement initiatives.

Basic Qualifications:

• Education:

Associates or Bachelor’s degree in business or related field is preferred

Coding certification (e.g., CPC, RHIA, RHIT, CCS, or SCP) preferred.

• Experience:

At least 5 years experience in healthcare revenue cycle, billing and coding required.

• Licensure, Registrations & Certifications:

Certified Professional Coder (CPC) designation preferred. Requires and maintains a current valid driver’s license.

Essential Job Responsibilities:

• Ensures accurate and timely billing is occurring in accordance with specific payer requirements.
• Directly manage coding and encounter reconciliation functions of the medical group.
• Monitors billing holds and coordinates with other departments to obtain needed information.
• Establishes effective communication between coders and providers to address any deficiencies.
• Ensures all guidelines are followed and all corresponding reconciliation and month-end reports are completed in an accurate and timely manner.
• Develops policies and procedures related to coding and billing to improve revenue cycle integrity.
• Track numerous Key Performance Indicators such as denial rates, denial reasons, coding error rates, billing turnaround times, AR days.
• Directs coding processes to ensure accuracy, consistency and timeliness in the application of ICD-10, HCPCS, CPT and APC codes for both routine and complex procedures.
• Coordinates with Physician coding staff to maintain standard quality and productivity levels by monitoring workloads, task queues, workflow, etc.
• Oversees professional fee coding reviews, fiscal reviews and research efforts that support coding performance evaluation and process improvement initiatives.
• Provides direction for Physician coding staff regarding performance improvement initiatives based on coding review findings.
• Ensures excellent customer service and professionalism when interacting with staff, payers, patients and families to ensure all are treated with kindness and respect.
• Provide coding/documentation education to providers.
• Performs other related job duties as assigned, which could include special projects.