Admin Manager Inpatient Coding & Coding Quality

Admin Manager Inpatient Coding & Coding Quality

This position may be performed remotely from the following locations within the United States of America : Arkansas, Kansas, Missouri, Oklahoma, and Texas.

Please only apply if you live and work full-time in one of the states listed above or plan to relocate to one of these states before starting your employment with OU Health. State locations and specifics are subject to change as our hiring requirements shift.

General Description

The Coding Manager is responsible for assisting in the development and evolution of the overall strategy for the Company's coding operations. The Coding Manager manages, directs and coordinates the coding activities for the Company while driving strategic initiatives for overall company coding expectations and goals. Responsibilities include management of process, outcomes and personnel. The Coding Manager plans, assigns and directs the HIM coding and DRG / code validation workflow; actively monitors employee performance and rewards or disciplines accordingly; addresses complaints and resolves problems; and actively oversees and manages production and quality control efforts.

Essential Responsibilities

• Provides direct managerial oversight to Coding Integrity Specialists (CISs) I, II, and III, Coding Quality Reviewer / Educator(s), and Coding Lead(s) in management of all work processes and overall work responsibilities.
• Ensures complete, accurate, timely and consistent coding and DRG / code validation, while adhering to published coding guidelines and Company policy
• Actively reviews and manages data outcomes to identify root causes of coding quality issues for overall coding quality improvement
• Works in partnership across various teams to communicate production coding related issues such as workflow processes, forecasting, scheduling, quality activities, etc.
• Coaches and helps develop team members; helps resolve dysfunctional behavior within functional area(s); disciplines and counsel staff as necessary
• Proactively manages (including corresponding communications and escalation paths) significant issues in coding operations (e.g., productivity, TAT, quality), status of projects, barriers and successes
• Actively manages and monitors coding and clinical documentation improvement reconciliation operations
• Selects, evaluates, trains, and provides leadership and direction to reporting staff
• Responsible for review and improvement of process and services
• Responsible for ensuring employee work schedules sufficiently meet those requirements as established by the Leadership team
• Facilitates problem solving and collaboration within functional area(s)
• Works closely with other members of the Leadership Team in addressing issues related to accurate / timely coding, DRG / code validation, documentation, and unbilled management
• Works closely with other team members to address issues related to unbilled management, denials, medical necessity, payment compliance
• Responsible for ensuring staff compliance with documented and established workflow guidelines as it relates to adding and re-assigning accounts to work queues
• Coordinates and / or performs quality reviews of all direct reports' work
• Assists in the development of strategy, specific goals, objectives, budgets and performance standards for the coding, DRG / code validation and clinical documentation improvement operations
• Assists in identifying and implementing process improvements to decrease costs, increase accuracy and improve service for applicable stakeholders
• Coordinates and / or performs productivity monitoring and provides timely and consistent feedback to employees and Coding Director
• Coordinates and / or prepares coding and DRG / code validation benchmarking, productivity, quality, and reports for the Coding Director and Facility Leadership
• Promptly reports issues or trends to the appropriate member of the Leadership team, or other appropriate party
• Maintains up-to-date knowledge of regulatory changes impacting coding requirements and ensures staff are appropriately educated
• Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical / medical resources to assure coding knowledge and skills remain current
• Ensures employee compliance with Company educational requirements
• Coordinates work assignments
• Ensures safe work practices are being followed
• Coordinates training and education for all direct reports.
• Facilitates and / or participates in multi-disciplinary teams in addressing issues related to coding and clinical documentation improvement opportunities (as applicable)
• Practices and adheres to the "Code of Conduct" philosophy and "Mission and Value Statement"
• Other duties as assigned

Minimum Qualifications

Education : Bachelor's degree required.

Experience : 7 years recent inpatient / outpatient hospital coding experience (production, auditing and or managing) required. 3 to 5 years of progressive leadership experience in healthcare required. Experience managing a large coding pool or coding review pool strongly preferred.

License(s) / Certification(s) / Registration(s) Required : RHIA, RHIT, CPC, or CCS required.

Knowledge, Skills, and Abilities