Director of Coding

Nebraska Methodist Hospital•Omaha, NE

19h•Onsite

About The Position

Responsible for overseeing and managing all aspects of professional medical coding and billing operations within our healthcare facility. A strong understanding of medical coding practices and guidelines, as well as the ability to lead a team and ensure compliance with industry standards.

Requirements

Bachelor's degree in Health Information Management or related field OR equivalent combination of education/experience combined (one year of education equals one year of experience) required.
Minimum of 5 years of experience in medical coding, with at least 2 years in a leadership or supervisory role required.
Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification required.
Certified Risk Adjustment Coder (CRC) certification required.
Extensive knowledge of medical coding systems, practices, guidelines and regulations, including ICD-10-CM, CPT, and HCPCS Level II.
Familiarity with industry coding guidelines and regulations, including HIPAA and CMS regulations.
Strong leadership and management skills, with the ability to effectively manage a team and drive results.
Excellent communication and interpersonal skills, with the ability to collaborate with various stakeholders and build strong relationships.
Detail-oriented and analytical, with the ability to review and analyze coding data and identify areas for improvement.
Strong understanding of healthcare reimbursement methodologies and payment systems.
Proficiency in using coding software and electronic health record systems.
Problem-solving skills, with the ability to identify coding issues and develop solutions to ensure compliance and accuracy.

Nice To Haves

Certified Professional Medical Auditor (CPMA) certification preferred.

Responsibilities

Establish and maintaining coding policies and procedures in accordance with industry standards and regulations. This includes ensuring compliance with coding guidelines such as ICD-10-CM, CPT, and HCPCS Level II.
Oversee a team of medical coders and providing guidance and support to ensure accurate and timely coding. This includes assigning work, conducting performance evaluations, and providing necessary training and education to keep the team up to date with coding changes.
Maintain a high level of coding accuracy and ensuring compliance with coding regulations and guidelines. This includes conducting regular audits and reviews to identify and address coding errors, as well as implementing corrective actions when necessary.
Continuously stay informed of coding changes and updates, as well as industry regulations, to ensure compliance. This includes attending workshops, seminars, and conferences, and staying connected with professional coding organizations.
Collaborate with other departments within the healthcare facility, such as revenue cycle management, compliance, and clinical documentation improvement, to ensure effective communication and coordination of coding processes.
Provide ongoing education and training to healthcare providers, coders, and other relevant staff to ensure they are knowledgeable about coding guidelines and practices. This includes conducting training sessions, creating educational materials, and providing guidance on coding-related queries.
Oversight of all billing practices related to MPC in collaboration with revenue cycle, finance and billing departments for the health system. This will include pricing structures as well as best practice for professional billing. Monitor relevant denial and payer rejection trends for escalation to payers.
Oversee staff and analytics related to physician compensation. Stay up to date on change in wRVus and CMS changes related to fee schedules. Responsible for assignment of wRVU value analysis and policies and resolution of provider wRVU inquiries and discrepancies.