Director Professional (PB) Coding

Description

Summary:

The Director of Professional Coding is responsible for the direction and leadership of operational, financial, workforce management, for Professional (Pro-fee) Coding, Audit, and Education departments. This includes establishing, meeting and continuously monitoring the goals and objectives while maintaining alignment with the strategic goals and objectives for Christus Trinity Clinic. While the range of duties and responsibilities is broad and varied, the position includes directing the day-to-day operations, budgeting, productivity, coding compliance, and human resource management. The Director works closely with a variety of stakeholders, coordinating the activities of Professional Coding across the system. The Director is responsible for a diverse, growing department, requiring skills in data-driven decision-making, project management, and process improvement/lean management. This position requires a deep knowledge of industry best practices in pro-fee coding and documentation, technology and workflow. The Director will use these skills and experience to partner with physicians, department managers, coding leads/managers, Education Director, revenue cycle (CBO) and revenue integrity departments, and other clinical and non-clinical operational stakeholders in a highly complex professional coding model, to maximize patient and provider experience from a coding perspective, while increasing coding accuracy and efficiency.

MAJOR RESPONSIBILITIES:

· Conducts themselves in a manner that upholds CHRISTUS core values.

· Interprets impact of broad scope organizational change for staff and develops change strategies for successful implementation.

· Leverages leadership competencies to develop themselves and others.

· Develops and manages operational initiatives with measurable outcomes.

· Formulates objectives, goals and strategies collaboratively with other stakeholders.

· Prepares and delivers reports to operational leadership outlining progress toward meeting goals and objectives, to include performance related to pre-AR aging, work queue management, finance, quality, and staffing.

· Actively seeks opportunities to improve financial outcomes, engaging staff in the process.

· Monitors and analyzes data and utilizes for decisions regarding FTE’s, staffing and operational budget.

· Creates business plan(s)/SBARs in support of operational and staffing needs, analyzing cost benefit of programs and resources to support coding operations.

· Directs and provides guidance to managers to effectively allocate resources based on charge volume, budget constraints, and program priorities, goals, and objectives.

· Contribute to the success of the Christus Trinity Clinic by providing leadership, direction and coordination of operations, finances, and staffing for area of responsibility.

· Manage and direct all activities within area of responsibility.

· Continually assesses all services, identifies problems, utilizes data to analyze and propose innovative approaches for solutions.

· Engages staff and other stakeholders in continuous improvement of systems and processes; manages resources for staff participation in improvement work activities.

· Ensures effective facilitation of improvement teams and development of leadership skills to ensure overall effectiveness of meetings.

· Organizes and prioritizes time and resources to manage efficiency.

· Remains current of new coding and documentation guidelines, best practices and incorporates into Professional Coding practices and programs.

· Serve as subject matter expert in Evaluation & Management (E/M) coding and documentation requirements, CPT, ICD-10-CM, HCC, and HCPCS assignments.

· Serve as subject matter expert in Resident/Teaching Physician coding and documentation guidelines, CMS’ Incident-To and Split/Shared rules.

· Articulate and enforce standards for quality/productivity.

· Demonstrates achievable and measurable results and develop action plans for improvement.

· Initiates, monitors, and enforces all regulatory requirements including: CMS, NCCI, HIPAA, etc.

· Holds self and others accountable to policy, standards and commitments and provides timely follow through on questions and concerns.

· Actively listens to staff ideas and concerns, assesses others communication styles and adapts to them.

· Effectively facilitates meetings within Coding, Compliance, Revenue Cycle Operations and Clinical Operations.

· Creates bi-directional systems that effectively communicate information and data with various teams, providers, etc.

· Articulates and presents data, information, and ideas in a clear and concise manner.

· Communicates opinions and ideas in a nonthreatening and nonjudgmental manner to staff, peers, and others.

· Communicates with physicians, department leaders, and senior administration to maintain coordination with other CHRISTUS programs and departments.

· Manages the complex interdepartmental and interdisciplinary relationships to assure collaboration and effective/efficient operations within Coding Operations, Compliance, Revenue Integrity, and Revenue Cycle.

· Creates an environment that encourages diverse opinion, recognizes differences, and incorporates into process and services.

· Exhibits awareness of personal attitudes and beliefs, recognizing its effect on response to others.

· Creates a culture for recognizing and rewarding staff.

· Creates and maintains a satisfying workplace that fosters professional growth and job satisfaction for all members.

· Interviews to select top talent, matching Professional Coding Operations needs with appropriate skill sets.

· Identifies and addresses professional growth needs of self and others.

· Assesses manager, lead and staff development needs, identifies goals and provides resources.

· Identifies lack of competency in performance and establishes a corrective action plan (CAP) which includes goals, interventions, and measures.

· Maintains membership in professional organization(s) to develop knowledge and resources through networking, continuing education, and participation in national, regional, and/or local activities.

· Ensures integration of ethical standards and CHRISTUS core values into everyday work activities.

Requirements:

Education

Minimum –

· Bachelor’s Degree in Health Information Management (HIM) or other healthcare-related field

· Four (4) years of relevant experience may be considered in lieu of degree in addition to the experience below.

Preferred –

· Master’s Degree in related field

Work Experience

Minimum –

· Five (5) years management experience in Professional (Pro-fee) Medical Coding and three (3) plus years hands-on professional coding experience for a large health care facility, clinic, or consulting organization.

Preferred –

· Five (5) years management experience in Professional (Pro-fee) Medical Coding and three (3) plus years hands-on professional coding experience for a large health care system

· Experience in EPIC

Certifications – Certified Professional Coder (CPC) or Certified Coding Specialist Professional (CCS-P). Additional AAPC specialty certifications, RHIT, RHIA, would be a plus.

Required Skills, Knowledge, and Abilities

· Proficiency in 2023 E/M coding and documentation guidelines

· Proficiency in CPT, ICD-10-CM, HCPCs coding for professional services

· Demonstrated understanding of CMS/NCCI guidelines

· Knowledge of principles used for compliant coding

· Ability to operate in high-pressure situations

· Effective analytical ability in order to develop and analyze options, recommend solutions to and solve complex problems and issues

· Ability to function independently and deal with multiple, simultaneous projects

· Excellent communication and interpersonal skills to include the ability to negotiate and resolve conflicts and build teams

· Demonstrated creativity and flexibility

· Excellent organizational skills

· Knowledge of HIPAA and other compliance requirements

· Demonstrated innovative approach to problem resolution

· Ability to work collaboratively across CHRISTUS Health entities and disciplines

· Effective organizational, planning and project management abilities

· Ability to recognize personal strengths and weaknesses and develop goals for professional growth and achievement

· Ability to demonstrate a commitment to quality and excellence

· Effective leadership abilities:

o Ability to implement change in a positive, sensitive and forward - thinking manner

o Planning and problem solving

o Developing goals and objectives, and establishing priorities

o Inspires confidence, appropriate risk taking and achievement of high standards

o Self-starter with a willingness to try new ideas

o Positive, can-do attitude coupled with a sense of urgency

o Good judgment and ability to act decisively at the right time

o Ability to persuade others and develop consensus

o Effective communication skills both in written and verbal presentation with a communication style that is open in order to foster trust, credibility and understanding

o Effective collaboration and promotion of teamwork

Work Type:

Full Time

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