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Director of Clinical Coding Job in Rochester, New York

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Job Title: Director of Clinical Coding

Employer:	Cognisight
Type:	FULL TIME
Skills:	HCC & ICD-10 coding experience in Medicare Advantage,PACE,Commercial & Medicaid Managed Care risk adjustment models,Leadership experience managing staff and work processes,Ability to communicate and present to clients and providers,Ability to present at health field industry conferences as a subject matter expert in coding related topics
Required Certifications:	and RHIT/RHIA and required.,Health Information Management and Coding Certification(s)/Certified Professional Coder with 10+ years of a combination of coding and management experience. CPC and/or CRC
Required Experience:	11 to 100 years
Preferred Experience:	11 to 100 years
Location:	100 Kings Highway South, Suite 2500 Rochester 14617, NY, US
Date Posted:	6/26/2018

Cognisight, LLC, is a wholly-owned subsidiary of the greater Rochester Independent Practice Association (GRIPA). GRIPA is an IPA/Accountable Care Organization owned equally by the ~1,500 private and employed primary and specialty physicians and Rochester Regional Health serving the Greater Rochester NY area. We are committed to improving the health care quality of our client’s members and meeting the changing demands of risk adjusted reimbursement. We offer competitive wages, 401k plan, excellent health benefits and paid vacation time.

The Director of Clinical Coding leads the coding department for Medicare Advantage, PACE, Commercial, and Medicaid Managed Care product lines. Cognisight enters into a contractual agreement with a Plan/Issuer, ACO, or IPA and assists these plans in the identification, capture, and verification of risk adjustment diagnoses.

Requirements

Full Time Days; occasional weekends during peak periods

85% Management and QA responsibilities
15% Medical Record Review
A successful candidate must possess:
Health Information Management and Coding Certification(s)/Certified Professional Coder with 10+ years of a combination of coding and management experience. CPC and/or CRC, and RHIT/RHIA and required.
In addition, the following is required:

HCC & ICD-10 coding experience in Medicare Advantage, PACE, Commercial & Medicaid Managed Care risk adjustment models
Leadership experience managing staff and work processes
Ability to communicate and present to clients and providers
Ability to present at health field industry conferences as a subject matter expert in coding related topics
Candidate must be able to:

Define coding department work plan as aligned to Cognisight’s strategic plan and services; operationalize, report progress, and identify gap closing support requirements
Participate on the leadership team and represent the coding department
Provide Cognisight leadership team with enhancements required in product development
Provide clinical intellect and expertise to system analytics via project assignment as well as on an ad hoc basis
Collaborative input to Cognisight policy and procedure development & updates
Develop and monitor resource plan - Hire/Train/Manage/Direct all Lead Coders and Coding Liaisons
Work with our contracted vendors to bring on per diem contracted reviewers for our peak coding periods.
Monitor/Manage the work load for all reviewers with assistance from Lead Coders. Work with Director of Account Management and Operations Team to prioritize the work load
Through the lead coding trainer, continually educate Clinical Staff (internal & contracted) on our internal coding guidelines
- Assist Lead Coders in creating and maintaining training documents
- Develop and maintain detailed internal coding guidelines to be in sync with the CMS and ICD10 coding guidelines etc.
Through the lead coders, help develop goals and progress reporting for all coders (internal & contracted)
- Monitor the productivity and quality of all coders and act as necessary with lead coders
Lead client engagement related to Coding information
- Create and conduct provider and coder training for clients when necessary (via on-site and webinars)
- Participate in client meetings when necessary (via on-site and webinars) and take the lead when coding is the subject
Attend conferences and present on coding subject matters when necessary
Review records as time allows, to maintain coding skills and knowledge- 15% of time
Ensure coding staff adheres to:

• Workflows, requirements and timelines of client

• CMS/HHS/State guidelines

• DOH guidelines

• HIPAA, HiTech, & Fraud, Waste, & Abuse regulations

• All required coding guidelines

• Keeping all coding credentials current

Attributes- Ability to:

Lead and work within a high functioning team including many interdependencies and work flows
Communicate and resolve questions timely and efficiently
Use a variety of software tools and reporting
Travel when required (~20%)
Understand, respect, and apply client specific guidelines
Navigate various EMR systems

Please note: we do NOT provide relocation assistance