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HIM Director, Coding Operations Job in Georgetown, Texas

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Job Title: HIM Director, Coding Operations

Employer:Med Claims Compliance Corp
Preferred Certifications:CPC,RHIA,CCCS,RHIT,CCS-P
Required Experience:3 to 4 years
Preferred Experience:5 to 7 years
Location:723 W University Ave #312 Georgetown 78626, TX, US
Date Posted:11/18/2020

Medical Claim Compliance Corporation is changing how healthcare is delivered, processed and paid. Physicians can focus on quality care for patients and ensure accurate, complete documentation and coding. What makes MCC special is our dynamic team.  

HIM Director-Coding Operations 


Responsible for oversight of the 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 medical encounters in various clinical settings ranging from hospital systems to individual providers.   The Director will head up the review process for documentation of providers, coding and provide education and improvement bench marks in all areas of documentation and coding. This individual also develops and maintains policies and procedures that will improve and support the provider documentation and coding practices within the company and with participating providers to ensure timely, accurate and complete documentation and coding. This includes management and 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 direction for professional documentation and coding related activities, audits, education, and monitoring.

·         Provides day-to-day oversight of operations for the department responsible for Hierarchical Condition Category (HCC) / Clinical Quality Coding, risk adjustment, and reporting measures.

·         Initiate workflow improvements and standardization to increase efficiency and accuracy of documentation and coding for all services and providers

·         Serve as a liaison between 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

·         Set performance standards and conduct evaluations

·         Effectively communicates with providers, must be able to speak about clinical encounters to include, evaluation and management based on documentation with both providers and coders.

·         Provides timely feedback to providers/coders and take corrective action to ensure quality measures.

·         Implements annual provider audit programs to evaluate compliance with policy, coding (ICD-10, CPT and HCPCS), billing (NCCI, etc), and regulatory (CMS) requirements.

·         Proficient with ICD-10 and HCC coding as well as E&M and all professional coding guidelines for large multi-specialty provider groups.

·         Stay abreast of governing regulations and will be responsible for providing coding and compliance related education. 



·         Coding Certifications (RHIA, RHIT, CCS, CCS-P, CPC)

·         5 years of healthcare experience required

·         3-5 years of hands on professional coding experience large multi-specialty group

·         3 years of experience assisting provider documentation and managing physician queries.

·         Strong knowledge and experience with Medicare guidelines and authorization requirements

·         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



Bachelor's degree in a health information management or other healthcare-related field

Master's degree in related field preferred





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