Cincinnati Children's Hospitalis conducting a search for aDirector, Professional and Hospital Coding Services to plan, direct, organize and implement coding functions of the newly formed Coding Services Department in order to meet fiscal, patient care, research and teaching needs. This position will report to the Vice President, Revenue Cycle Management.
ABOUT CINCINNATI CHILDREN'S HOSPITAL
Cincinnati Children's Hospital, a nonprofit academic medical center established in 1883, and is one of the oldest and most distinguished pediatric hospitals in the United States. We offer comprehensive clinical services, from treatments for rare and complex conditions to well-child care. In the 2016-17U.S. News & World Report survey of best children's hospitals, Cincinnati Children's ranked No. 3 among all Honor Roll hospitals. With more than 600 registered beds, Cincinnati Children's had more than 1.2 million patient encounters and served patients from all 50 states and 68 countries in fiscal 2015.
DUTIES & RESPONSIBILITIES
Develop coding centralization plans and outpatient billing and coding integration, including professional and hospital services
Serve as a coding and APR-DRG and APC/EAPG resource to medical staff, other hospital personnel, clinical departments and Revenue Cycle Management
Monitor and audit coding quality and abstracting for both diagnostic and procedural coding assignments to ensure compliance with all applicable governmental policies, laws and regulations; train and evaluate the activities of coding personnel
Participate in budget development by providing detailed justification for proposals or initiatives
Work closely with physicians and the Business Director/Manager to ensure appropriate clinical documentation that supports coding; and analyze availability and use of technology/automated tools that support coding initiatives
Participate in the revenue cycle process, working closely with Revenue Cycle Management and other services to assist in resolving account, coding and charge capture issues
EDUCATION & EXPERIENCE REQUIREMENTS
The Director of Coding requires thorough medical records coding knowledge and experience in hospital inpatient and outpatient settings, as well as physician professional services, relating to ICD-10-CMS/PCS, CPT®, HCPCS, APR-DRG and APC/EAPG assignments, Charge Description Master, coding software, including groupers, compliance tools, editors and encoders and third party billing guidelines and regulations.
Ideal candidates will have a Bachelor's Degree in a health care related field, be either as a Registered Health Information Administrator (RHIA) or a Registered Health Information Technician (RHIT), and have seven (7) years of related management experience with at least 3-5 years of coding management experience. Operational and supervisory experience and experience in a complex medical center required and pediatric academic medical center environment preferred.
PURPOSE OF POSITION: To plan, direct, organize and implement assigned functions of the Coding Services Department in order to meet the fiscal, patient care, research and teaching needs of a Medical Center dedicated to the care of infants, children and adolescents.
Manage the business activities of the Coding Services Department assigned areas of responsibilities. Participate in the management of annual fiscal operating and capital equipment budgets for the Coding Services Department. Participate in the budgeting process. Provide guidance, support, and oversight to the organization and ensure effective management of internal and external audits of the medical record documentation for coding accuracy. Analyze trends to identify patterns and variations in department practices such as productivity,quality, accuracy, and case mix index. Compare department profile with national and CHA (Children's Hospital Association) norms to identify variations requiring further investigation.
• Technology Management
Plan and direct the implementation of Coding Services systems, applications, and technology. Participate with Information Services in the design and implementation of various information systems for coding, encoding, and abstracting that assist in professional and hospital coding processes.Direct project teams in the development and implementation of complex information technology to include the creation and management of project plans that include measurable and accountable milestones. Evaluate current system functions for efficiency, effectiveness, and accuracy. Resolve technical problems as they arise.
• Personnel Administration
Manage the selection, development, motivation, appraisal and discipline of reporting personnel and oversee the process for indirect reports. Allocate resources regarding staffing requirements. Control accurate payroll records. Develop and maintain working relationships and serve as a resource to the Medical Staff, and other providers regarding coding practices. Assess, develop, and implement departmental policies or procedures and philosophy as consistent with Cincinnati Children's policies and values. Maintain currency in all departmental policies, procedures, standards and job descriptions in area of responsibility. Promote both internal and external customer service through the development and implementation of programs and standards. Monitor continuing education goals and training for all staff (direct and indirect reports) of areas of responsibility. Provide training to Coding Services staff and internal customers of Coding Services as necessary through structured presentations and unstructured interactions. Support the manager in making job requirements and goals for each position clear to employees
• Administrative Development
Monitor and assure the compliance government and regulatory agencies Represent the Coding Services Department at hospital administration meetings. Act as a liaison with various vendors utilized within the Coding Services Department. Plan, develop, and manage special projects. Identify service areas, plan approaches for improvement activities, design new processes with specifications and expectations against which success can be measured, systematically measure collected data, assess performance over time, improve and redesign processes based on the evaluation, and reassess continuously.
Remain up to date on all aspects of professional and hospital coding. Work closely with the divisional Business Director(s)/Manager(s) to ensure appropriate coding of professional services bills and with hospital department Business Director(s)/Manager(s) to ensure appropriate coding of hospital services. Work closely with Revenue Cycle departments to ensure accurate coding and billing practices and resolution of claim edits and issues associated with code assignments.
Develop methods for analysis, conduct financial and quantitative analysis and monitor existing/proposed program services. Monitor service areas, plan approaches for improvement activities, design new processes, collect and measure data, review and report performance over time, improve and redesign processes based on the evaluation and reassess continuously.
Bachelor's Degree in a health care related field
Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) with both professional and hospital coding experience
7 years related experience, minimum of 3-5 years of coding management experience
Operational and supervisory experience within a complex Medical Center
Skills & Competencies
Expressing oneself verbally in an accurate, understandable, and succinct manner to individuals or groups; using appropriate non-verbal signals to emphasize spoken words; adapting communication style and tone to fit the situation and audience; demonstrating poise during group discussions or formal presentations; holding others' attention; responding clearly and tactfully to questions
Understanding and showing respect and appreciation for the uniqueness of all individuals; leveraging differences in others' perspectives and ideas; appreciating cultural differences and adjusting one's approach to successfully integrate with others who are different from oneself
Medical Terminology - Intermediate
Intermediate knowledge of medical terminology
Proficiency in basic computer applications such as Microsoft Office (Word, Excel, Access), e-mail, and internet
Demonstrates an independent work initiative, sound judgment, diplomacy, tact and professional demeanor
Effective verbal, written and/or interpersonal communication skills
Expert Knowledge of ICD9/10-CM and PCS, and CPT/HCPCScoding classification systems and guidelines and Prospective payment Systems, billing processes, and grouping methodologies such as DRG's, APR-DRG's, EAPG's, etc. Knowledgeable in CMS, Medicaid, and other regulatory agency rules and regulations. Knowledgeable in the use and analysis of CODING SERVICES patient information systems applications.