The Professional Coding Director is responsible for oversight of the professional coding department, developing, implementing, and maintaining a system-wide quality management plan and facilitating improvement in overall quality, completeness, appropriateness and accuracy of documentation and coding for professional services. The Director will review coding and documentation by CHRISTUS Trinity Clinic (CTC) providers and coders and provide education in all divisions of the Clinics. This individual also develops and maintains policies and procedures that will improve and support the provider documentation and coding practices within CTC--as well as promote timely, accurate and complete documentation and coding. This includes oversight of Coding associates day to day operations, audits, hiring, termination, evaluations, etc. The Director utilizes project management skills, clinical knowledge, and understanding of documentation and coding requirements to improve day to day operations, processes and compliance.
Provide system-wide direction for professional documentation and coding related activities, audits, education, and monitoring
Initiate workflow improvements and standardization to increase efficiency and accuracy of documentation and coding for all services and providers
Serve as a liaison between clinical providers and coders to resolve documentation and coding issues
Establish, implement, and maintain a formalized review process for coding and documentation compliance, including a formal audit process and quality control system
Assess current compliance activities and evaluate risk factors in coding and documentation practices and implement strategies to mitigate risk, educate providers and coders
Set performance standards and conduct evaluations; drive educational programming, if necessary, to improve data quality
Monitor reports related to coding, documentation trends and results and provide feedback and education to providers and coders
Produce and analyze system-wide reports on providers coding DNFB, edits, audits, etc
Effectively communicates with providers, must be able to speak to the level of how to E&M level based on documentation with both providers and coders.
Provides timely feedback to providers/coders and take corrective action to ensure education is effective
Proficient with ICD-10 and HCC coding as well as E&M and all professional coding guidelines for large multi-specialty provider groups
Bachelor's degree in a health information management or other healthcare-related field required
Master's degree in related field preferred
Completion and mastery of coursework in human anatomy and physiology; ICD and CPT coding; and medical terminology preferred
Applicable HIM and coding credentials and certifications (RHIA, RHIT, CCS, CCS-P, CPC)
5 years of healthcare experience required; at least 3 years of progressive responsibility preferred
3-5 years of hands on professional coding experience large multi-specialty group
3+ years of experience as a trainer / educator to physicians and coders
Strong working knowledge of ICD coding classification systems, CPT and E&M guidelines
Working knowledge of coding for third party payers including CMS guidelines and reimbursement compliance
Knowledge of HIPAA, JCAHO, and other compliance requirements
Knowledge of health information systems and database technology
Proven organizational and project management skills Demonstrated team development and interpersonal skills
Strong analytical and problem-solving skills
Strong communication and presentation skills
Basic computer skills (i.e., word-processing, spreadsheets, and menu-driven software)
Demonstrated ability as a leader
