Director, PB Coding Operations – Education

Role Overview

• Provide coding oversight and standards to ensure coding accuracy, compliance and appropriate reimbursement across BUMG.
• Manage operational execution of coding standards in areas reporting to Revenue Cycle.
• Facilitate accurate representation of professional coding and clinical documentation through interaction with physicians, coders and practice staff by providing ongoing education.
• Direct coding activities to ensure accurate, consistent and compliant coding for all services.
• Ensure quality reviews to validate coding accuracy.
• Participate in the rejections, denials and claims review process with billing team to ensure compliance and accurate reimbursement.
• Identify trends in documentation and coding concerns and collaborate with Leadership and Compliance to assess and implement corrective action.
• Evaluate the success of coding processes on an ongoing basis.
• Serve as contact for professional coding across BUMG.
• Work with Human Resources and department managers on the selection of qualified candidates for employment following all policies, guidelines and applicable laws.
• Responsible for effective personnel management including training, directing, mentoring and instilling a commitment to quality and excellence.
• Monitor department productivity and performance to identify and evaluate program/department strengths and training opportunities in relation to operative effectiveness.
• Encourage staff and personally advances professional growth and development through participation in educational programs, workshops and maintaining knowledge of industry standards and practices.

Requirements

• Bachelor’s degree or equivalent combination of formal education and experience.
• CPC – Certified Professional Coder
• Minimum of 10 years related experience in professional coding with ICD-9/ICD-10, E/M and CPT.
• Previous management experience required; experience must include education/mentoring/training.
• Expertise knowledge of ICD-9/ICD-10, CPT and E&M coding principals and guidelines
• Knowledge of MS, AP, and APR DRG systems
• Knowledge of payer reimbursement methodologies, federal, state and payer specific regulations, policies and compliance standards
• Excellent written verbal and communication skills
• Excellent critical thinking skills
• Excellent skill in providing hands-on education to providers including audit finding and improvement opportunities.
• Excellent organizational skills, including ability to multi-task, prioritize essential tasks, follow-through and meet timelines.
• Ability to work cooperatively with members of the healthcare delivery team and staff
• Ability to adapt to changes in workload and priorities, responding quickly to urgent requests.
• Ability to mentor, guide and motivate direct reports through demonstration of best practices and leading by example.

Benefits

• medical, dental, vision, pharmacy
• discretionary annual bonuses
• merit increases
• Flexible Spending Accounts
• 403(b) savings matches
• paid time off
• career advancement opportunities
• resources to support employee and family well-being