General Summary: An exempt position providing leadership and
vision for strategic planning and quality improvement projects and initiatives.
Serves as liaison to Wright State Physicians administration, medical staff, and
Essential Job Responsibilities:
Oversees the operation of the clinical coding and
compliance areas within Wright State Physicians, including inpatient/outpatient
coding, clinical data abstraction, report writing, and HIPAA compliance.
Reviews billing requirements and develops and maintains
policies and procedures that support clinical coding and compliance, and
ensures appropriate coding of services.
Collaborates with the medical staff and departments to
ensure the quality and consistency of clinical documentation.
Coordinates audits of coding and documentation
practices and initiates continuous improvement activities to ensure coding
compliance with regulatory requirements.
Conducts education and training programs to keep staff,
providers and departments current on coding, reimbursement, compliance and
regulatory changes and procedures.
Assesses staff educational needs and plans appropriate methods to meet
developmental needs, including resident training, as appropriate.
Continuously assesses functional work processes, initiating
changes as needed to improve efficiency and effectiveness, and moves the
clinical coding functions toward industry best practices.
Manages employees (direct reports) including,
counseling, conducting performance appraisals, interview, etc. and provides
instruction to staff and management as necessary.
Monitors quality and productivity of staff including
audits on staff work.
Monitors and reports key financial and operational
indicators related to coding and identifies trends, issues and risk areas to
with other staff and departments to continually improve the flow of patient
information and resolve issues or inconsistencies with coding compliance,
charge capture and data/information.
with internal and external customers to define abstract data elements;
establishes policies and procedures related to data capture, retention, and
retrieval; assists end users in translating data into useful information.
current on all coding, reimbursement and compliance guidelines.
automation and computer systems effectively to maintain privacy and maximize
productivity, quality, and customer service.
the implementation of new coding rules and all other coding related changes.
Education/Certifications: Bachelor’s degree or the
equivalent combination of education and experience is required in Health
Information or related field preferred. Requires Certified Coding Specialist
(CCS or CCS-P); or Certified Professional Coder (CPC). Certified Professional
Medical Auditor (CPMA) recommended
Experience: Minimum 2 years
clinical coding supervisory and acute care coding experiences required.
The employee is
expected to protect the privacy of all patient/client information in accordance
with Wright State Physicians privacy policies, procedures and practices as
required by Federal (and State) law and in accordance with general principles
of professionalism as a health care provider.
Maintain knowledge of CMS’s incentive program standards and other
payers’ quality programs. Possess strong
communication and presentation skills.
the confidentiality of all patient/staff records.
participant with teams involved with process improvements.
abreast of and ensures compliance with regulatory guidelines, accreditation
bodies and system policy/procedure for all activities within practice.
communication with leaders on an ongoing basis to review performance targets as
well as other projects as defined by the Medical Group Executive and the
Director of Revenue Cycle.