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UnityPoint Health Manager Coding Quality in West Des Moines, Iowa

The Coding Quality Manager is responsible for the development, evolution, and implementation of the overall strategy of the organization’s coding quality operations. The manager is responsible for directing and coordinating coding quality monitoring activities and will work with coding leadership to improve the accuracy, integrity, and quality of patient data, to ensure minimal variation in coding practices and improve the quality of coding. The manager will communicate with clinical informatics, clinical documentation integrity and coding leadership opportunities for improvement in physician documentation in the medical record to support code assignments. The manager plans, assigns, and directors the coding quality monitoring program, actively monitors staff performance, and actively oversees and managers production and quality control efforts. Identifies opportunities to improve audit effectiveness and efficiency.

Management of Coding Quality Review

  • Develop a coding quality review plan which employs a risk-based methodology in collaboration with the Executive Director HIM/Coding and input from hospital and professional coding directors.

  • Addresses and assesses management’s risk mitigation strategies and ensures coding quality reviews are scoped and resourced appropriately.

  • Provide direct managerial oversight to the staff in the Coding Quality Department in the management of coding and data quality and education work processes, to include coding quality reviews that include but not limited to pre and post billing coding reviews.

  • Serve as a resource for coding compliance issues related to Federal, State and third-party reimbursement matters, including coding, billing and other regulatory issues and adherence to UnityPoint Health policies and procedures.

  • Coordinates work assignments to achieve operational goals.

  • Proactively manages significant issues in coding, status of projects, barriers, and successes, including corresponding communication and escalation.

  • Report findings of variance in expected versus actual documentation required by payers, organizational policies and procedures, and Federal and State requirements.

  • Based on coding quality review findings, conduct trainings sessions when needed.

  • Assist in the development of provider and staff educational materials.

  • Review publication updates, including government and professional publications to remain current.

  • Supervise and mentor staff, assist in the development of their skills such as communication, organization, and delivery of work products in addition to review of staff work product and feedback. Responsible for hiring, discipline and performance evaluation of assigned staff

  • Reports coding quality review results to the Executive Director of HIM/Coding and other UnityPoint Health committees

  • Manages department goals, policies and procedures, budgets and work ethics to contribute to department effectiveness.

  • Serve as member on corporate and regional compliance committees, when directed.

  • Works in collaboration with the Executive Director of HIM / Coding in establishing departmental goals, standards and procedures to ensure optimal team efficiency, effectiveness, and functionality.

  • Maintains a high level of independence and objectivity.

  • Performs special audit assignments and investigations as required.

  • Serve as a resource for coding questions and compliance issues providing guidance and expertise in the interpretation of, and adherence to, the rules and regulations for documentation and coding.

Improvement

  • Develops communication tools to drive Coding Quality awareness across UnityPoint Health and Clinics. These tools may include internal controls presentations and questionnaires with the intent to improve compliance and operating effectiveness with reimbursement, regulatory, and UnityPoint Health policies and procedures.

  • Participate in process improvement projects with management to provide education regarding coding quality review services.

  • Participates in establishing and preparing departmental goals, standards, procedures and instructions which contribute to the efficiency and effectiveness of the department.

  • Develops and maintains coding quality departmental policies and procedures based on best practices in the industry,

  • Works to achieve a level of quality that meets applicable professional standards and promotes best practices in coding quality review.

Education:

  • Associates degree in Health Information Management/Health Information Technology, healthcare or another business-related field with equivalent experience

  • Bachelor’s degree in Health Information Management preferred

Experience:

  • Minimum of 6 years coding/ auditing experience in healthcare setting

  • Minimum of 3 years coding/auditing experience in both professional and hospital coding preferred

License(s)/Certification(s):

  • Registered Health Information Technician (RHIT), or Certified Coding Specialist (CCS), Certified Coding Specialist -Physician Based (CCS-P) Certified Professional Coder (COC/CPC), Certified Inpatient Coder (CIC), Certified Professional Coder – Hospital Outpatient (CPC-H)

  • Registered Health Information Administrator (RHIA) preferred

Knowledge/Skills/Abilities:

  • Highly developed written and verbal communication skills to effectively work with all levels of management and staff throughout the organization

  • Ability to work as a team member, maintaining effective working relationships; ability to develop and maintain team environment.

  • Ability to understand and apply guidelines, policies and procedures

  • Proficient understanding of Microsoft Office products: Excel, Word, and Outlook

  • Familiarity with the Epic electronic medical records platform preferred

Requisition ID: 2021-90115

Street: 1776 West Lakes Pkwy

Name: 9010 Administration

Name: Coding - Auditing & Education

FTE (Numeric Only; Ex. 0.01): 1.0

FLSA Status: Exempt

Scheduled Hours/Shift: M- F 8 am to 5 pm

External Company URL: http://www.unitypoint.org

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