Director, Medical Coding and Chart Audit Services

Summary:

The Director Medical Coding and Chart Audit Services - HCS will be responsible for managing and overseeing professional outpatient coding and chart auditing services as well as facilitating medical documentation improvements for the Catholic Health providers and Healthcare Solutions private clients. Additionally the position is responsible to manage and reduce coding denials; assist implementing EMR updates to improve documentation accuracies and reduce coding denial rates; maintaining and updating the claim scrubbers ensuring all coding edits are current and compliant with applicable federal and state regulation and with CMS and AMA coding guidelines. The Director will be responsible to maintain coding education materials accurate and current based on coding guidelines and policies to be shared with all practices/private clients and team members. The individual also develops and maintains policies and procedures that will improve and support overall quality of coding and auditing services performed for CHS practices and HCS private clients. Ensuring proper education, training and quality audits are maintained will be a key function of this individual. This individual will have supervisory responsibilities over manager coding and chart auditing services, professional medical coders, auditors and coding vendors. Overall, the director will leverage project management skills, clinical knowledge, coding knowledge and understanding of regulatory guidelines to continuously improve processes and compliance along with managing professional outpatient coding and chart auditing services for CHS providers and HCS private clients.

Responsibilities:

EDUCATION

• Bachelor’s degree in a related health or science field
• Medical Coding certification through American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) is also required with multiple certifications a plus
• The successful candidate should have a thorough understanding of Current Procedural Terminology (CPT) codes, International Classification of Diseases (ICD-10) diagnosis codes and appropriate modifier use as well as experience with AHA Coding Clinic and CPT Assistant as resources

EXPERIENCE

• 3 - 5 years of multi-specialty professional coding experience required
• Minimum 3 years professional experience as a coding and auditing manager in health care system
• Epic experience highly recommended

KNOWLEDGE, SKILL AND ABILITY:

• Extensive knowledge of Medicare and Commercial Payers coding and billing policies
• Knowledge of National Correct Coding Initiatives (NCCI) edits, National and Local Coverage Determination Policies (NDC and LDC) and Medically Unlikely Edits (MUE)
• Experience working with EMR and practice management systems
• Strong research capabilities with respect to Medical procedures and technology; and an excellent knowledge of Medical terminology
• Excellent computer skills - Word, Excel, multiple EHR systems and electronic encoders
• Excellent communication skills
• Works well in a team environment and has the capability to multi-task several responsibilities
• Recognizes and protects the confidentiality of all patient and employee information according to HIPAA policy
• Interfaces well with external and internal Professionals at all levels- Medical, Legal, and Clerical

WORKING CONDITIONS:

• 7a-3:30p, hours may vary
• Normal heat, light space, and safe working environment; typical of most office jobs. Long periods of sitting