Manager, HIM Coding Audit & Education
The HIM Coding Audit and Education Manager shall be responsible for all inpatient and outpatient coding quality, accuracy, and audit functions. The position includes oversight over all three Steward Health Care divisions and shall report to the Executive Director, Health Information Management.
- Education: Bachelor’s degree required, Master’s preferred
- Experience 10 years progressive HIM Coding Management experience within an Acute Care Hospital setting. Extensive experience with Revenue Cycle operations including acute care coding.
- Certification/Licensure: RHIA or RHIT with CCS
- Software/Hardware: Cerner, Meditech, and 3M 360 experience required
- Other: Required to work out of Steward Health Care office located in Richardson, Texas.
- Travel: Expected travel is up to 10%. Education and/or company growth.
- Direct oversight of external coding audit functions that include annual performance monitoring of all coders.
- Responsible for capturing audit activity per coder and overall company coding audit performance.
- Responsible for all coding education duties that include annual IPPS and OPPS changes.
- Prepare monthly coder education newsletter.
- Direct management over Coding and Regulatory Change Educator.
- Prepare monthly external coding denial and audit report.
- Direct management over Inpatient Coding Auditors and Outpatient Coding Auditors.
- Direct management over Coding and Clinical Validation Appeal Specialists.
- Direct management over No CC/MCC and Low Relative Weight Reviewers.
- Maintain open communication with hospital and division leadership team.
- Promote a culture of collaboration between hospital leadership and shared service professionals.
- Coordinate workflow improvements with HIM Operations Management.
- Perform all Coder Assessments on all new coders including acquisitions. Includes new coder orientation.
- Perform all Coder Performance Action Plans and recommend course of action to Executive Director, Health Information Management.
- Responsible for all clinical validation and DRG downgrade appeals. Includes coordination with Division Manager, CDI and Steward Health Care physician leadership.
- Monitors OIG annual Work Plan and other industry publications for high risk claim situations and implement internal organization review.
- Work with other SHC senior leaders as needed.
- Implement a coder education platform and resources within company SharePoint infrastructure.
- Assists HIM Leadership team with development and implementation of health information management policies.
- Ensure SHC policies related to HIM, Revenue Cycle, and Compliance are implemented and monitored.
- Implement HIM related projects at the direction of the Executive Director, Health Information Management.
- Responsive to senior management during off hours and/or weekends.