Director Coding Operations Revenue Cycle
Source API remote eligibility restrictions: United States
Work from home (Pennsylvania)
Shift:
Days (United States of America), ESTFull-TimeDirector
Salary not disclosed
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Job Details
- Experience
- Minimum of 5 years-Managerial/Supervisory (Required), Minimum of 8 years-Relevant experience* (Required)
- Required Skills
- Compliance
Requirements
- One relevant certification from AHIMA or AAPC is required upon hire.
- Acceptable AHIMA certifications: Certified Coding Specialist (CCS), Certified Coding Specialist – Physician-based (CCS-P), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Associate (CCA).
- Candidates with only a CCA are required to obtain a CCS, RHIT, or RHIA within 12 months of hire.
- All AAPC certifications are acceptable except Scribe, Documentation, Instructor, International Credentials, Certified Professional Biller (CPB), Revenue Cycle Management Specialist (RCMS), Certified Value-Based Administrator (CVBA), Certified Physician Practice Manager (CPPM), Certified Professional Compliance Officer (CPCO).
- High School Diploma or Equivalent (GED)- (Required).
- Minimum of 5 years-Managerial/Supervisory (Required).
- Minimum of 8 years-Relevant experience* (Required).
Responsibilities
- Provides direction and management to the Professional Coding Operations Department.
- Responsible for the integrity, quality, accuracy and performance of the coding program.
- Responds to requests from billing office for claims holding in billing system as a result of payor edits or rejections.
- Reviews account detail and compare to the medical records for accurate selection of diagnoses and procedure codes as a quality measure for all coding activity.
- Provides consultative support to clinical areas on a daily basis for correct code reporting related to revenue enhancement.
- Acts as a liaison with physicians to ascertain and correct information needed to resolve discrepancies regarding diagnoses and procedures based on standard clinical pathways and translation of clinical data into coded form.
- Researches coding compliance, keeps up-to-date on areas of focus by the OIG, HCFA, PRS and other payors and review organizations Develops in concert with Coding Program Trainer materials for coding staff and physicians on documentation and coding issues.
- Conducts and documents training sessions related to Coding updates.
- Develops implements and directs various quality initiatives to ensure continuous monitoring and improvements within the revenue cycle process of Geisinger.
- Facilitates various technological initiatives in support of coding and business process improvements with respect to hospital and professional coding management operations.
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