Responsibilities

• Evaluates the impact of innovations and changes in programs, policies, and procedures for the coding unit
• Designs and implements systems and methods to improve data integrity and coding compliance
• Identifies, assesses, and resolves issues impacting coding, documentation, and revenue cycle processes
• Monitors and maintains acceptable accounts receivables associated with un-coded charts (DNFB), and team member productivity and accuracy according to industry standards
• Oversees and monitors the coding compliance program. Develops and coordinates educational and training programs such as appropriate documentation and accurate coding to all appropriate staff including coding staff, physicians, billing staff, and ancillary departments
• Ensures the appropriate dissemination and communication of regulatory, policy, and guideline changes in collaboration with HIM Management
• Conducts and oversees coding audit efforts and coordinates monitoring of coding accuracy and documentation adequacy
• Reports noncompliance issues detected through auditing and monitoring, the nature of corrective action plans, and the results of follow-up audits to the directors of hospital and the compliance officer
• Reviews claim denials and rejections pertaining to coding and/or support of medical necessity, when necessary, implements corrective action plan (such as educational programs) to prevent similar denials and rejections from recurring
• Interacts with a variety of people who impact the success of coding compliance program, and functions as a facilitator, liaison, and/or motivator
• Assess educational needs and process improvement via team member shadowing and weekly one-on-one with individual coder/team
• Manage coders’ time – PTO approvals to ensure coverage is maintained – Payroll System time keeper