Senior Director Professional Coding

Sanford Health • Sioux Falls, SD

2d • Onsite

About The Position

Responsible for overall design, implementation and optimization of hospital and professional coding for Sanford Health. Provides leadership in the areas of clinic and hospital professional coding, hospital inpatient and outpatient facility coding, and hospital and professional denials/audits. Provides strategic planning and technical leadership and input on information systems. Directs and provides leadership to hospital and professional coding staff. Directs the processes and resolution of clinic and hospital professional coding and hospital facility related denials. Provides direction and leadership for denial management and audit activity to include integrity of appeal process and policy. Demonstrates ability to develop, evaluate, monitor, educate, and analyze health system coding processes on a daily basis to increase productivity, ensure compliance is met utilizing all recognized coding guidelines and all payor policies and guidelines and the goals of Sanford Health are met. Responsible for operational budget and strategic initiatives and formulation of Sanford Health's coding operating model and enhancement of coding related services throughout the system in order to drive and meet the goals of revenue services. Organize and streamline operations to achieve financial and service objectives. Develop and manage a multi-million dollar annual budget. Work extensively with IT. Develops reporting tools for Sanford leadership to help in fiscal budget planning and decision making, as well as education to reduce denial/RAC activity for the system. Collaborates and coordinates with various Sanford Health leaders to ensure coding integrity and accurate data collection is achieved to support a seamless continuum of care, supporting provider compensation models, compliant processes, optimal reimbursement and efficient revenue cycle functions. Strengthens relationships by communicating department activity and outcome with other managers and service areas. Participate in revenue cycle strategies and initiatives. Demonstrate vision and leadership in strategic planning and manage multiple competing priorities and diverse viewpoints. Lead by example, with initiative, self- discipline, confidence and professionalism to encourage and enable a management team and staff. Sets vision and direction for developing and maintaining relationships between the Sanford provider community and coding. Supports Sanford's efforts to influence public policy at the state and federal levels. Must demonstrate a broad-based knowledge of coding and billing practices.

Requirements

• Bachelor’s degree required.
• Minimum seven years of directly related work experience.
• Extensive knowledge of basic and underlying Current Procedural Terminology (CPT) coding practices required.
• Minimum seven years of management experience in a large health care system with responsibility for coding practices.
• Extensive knowledge of state and federal laws, rules and regulations and must be able to accurately interpret and apply these laws, rules and regulations.
• Experience in health care finance, rate setting procedures, and intermediary auditing related to Medicare.
• Experience analyzing and maximizing third party reimbursement.
• Experience with computerized reporting systems.
• Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Outpatient Coder (COC) or Certified Coding Specialist (CCS) certification required.

Responsibilities

• Overall design, implementation and optimization of hospital and professional coding for Sanford Health.
• Provides leadership in the areas of clinic and hospital professional coding, hospital inpatient and outpatient facility coding, and hospital and professional denials/audits.
• Provides strategic planning and technical leadership and input on information systems.
• Directs and provides leadership to hospital and professional coding staff.
• Directs the processes and resolution of clinic and hospital professional coding and hospital facility related denials.
• Provides direction and leadership for denial management and audit activity to include integrity of appeal process and policy.
• Develops, evaluates, monitors, educates, and analyzes health system coding processes on a daily basis to increase productivity, ensure compliance, and meet payor policies and guidelines.
• Responsible for operational budget and strategic initiatives and formulation of Sanford Health's coding operating model and enhancement of coding related services.
• Organizes and streamlines operations to achieve financial and service objectives.
• Develops and manages a multi-million dollar annual budget.
• Works extensively with IT.
• Develops reporting tools for Sanford leadership for fiscal budget planning, decision making, and education to reduce denial/RAC activity.
• Collaborates and coordinates with various Sanford Health leaders to ensure coding integrity and accurate data collection.
• Participates in revenue cycle strategies and initiatives.
• Demonstrates vision and leadership in strategic planning and manages multiple competing priorities and diverse viewpoints.
• Leads by example with initiative, self-discipline, confidence and professionalism.
• Sets vision and direction for developing and maintaining relationships between the Sanford provider community and coding.
• Supports Sanford's efforts to influence public policy at the state and federal levels.
• Demonstrates a broad-based knowledge of coding and billing practices.

What This Job Offers

• Job Type: Full-time
• Career Level: Director