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Director, Coding And Compliance | Usa

7+ years
Not Disclosed
10 Nov. 13, 2024
Job Description
Job Type: Full Time Remote Education: B.Sc./ M.Sc./ M.Pharm/ B.Pharm/ Life Sciences Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

Job Title: Director of Coding Compliance and Education

Job Summary:
The Director of Coding Compliance and Education is responsible for overseeing the compliance of healthcare providers, hospitals, and medical facilities with all coding regulations, policies, and procedures. This role involves managing the training and education of coders, physicians, healthcare providers, and billing staff on clinical documentation improvement (CDI) and coding best practices. The Director ensures that medical records and coding documentation are accurate and that billing practices comply with federal and state laws. By collaborating with various departments, the Director plays a critical role in driving improvements in coding, billing practices, and regulatory compliance, contributing to enhanced patient care and the financial sustainability of the organization.

Qualifications:

  • Bachelor’s degree in a related field or equivalent combination of training, education, and experience (Required)
  • 5+ years of experience in Revenue Cycle Management
  • 10+ years of leadership and training experience (Required)
  • Experience with multiple practice management systems
  • Expert level proficiency in Microsoft Office (Word, Excel)
  • Ability to analyze data, identify trends, make recommendations, and justify changes
  • Strong written and verbal communication skills
  • Passion for continuous operational improvement
  • Certified coding certificate from AAPC or AHIMA (Required)
  • Knowledge of risk management and Health Information Management Systems (HIMS) experience
  • Progressive experience collaborating with medical staff leadership and senior management

Responsibilities:

  • Conduct regular audits of coding and billing practices to ensure compliance with regulations
  • Analyze coding data to identify trends, potential compliance issues, and areas for improvement
  • Stay up-to-date with changes in coding regulations, policies, and procedures
  • Design, develop, and implement coding education programs for staff and clients
  • Provide training to coding staff, physicians, and healthcare providers on CDI, coding guidelines, and compliance with regulatory requirements
  • Act as a liaison between coding staff and providers to resolve coding-related issues
  • Establish key metrics and performance indicators to monitor coding and billing practices
  • Manage recruiting, training, performance management, and reward systems for coding staff
  • Address elevated client expectations and proactively understand and resolve issues impacting success
  • Collaborate cross-functionally to ensure consistent client service levels
  • Lead the development and documentation of processes and workflows as assigned
  • Obtain monthly performance metrics and adhere to policies, ensuring compliance with governmental and HIPAA regulations
  • Ensure compliance with internal control responsibilities and organizational objectives
  • Safeguard Protected Health Information (PHI) in compliance with HIPAA

Work Environment:

  • Office-based, with occasional remote work