Revenue Cycle Coding Director Job in Ann Arbor, Michigan

BASIC FUNCTION AND RESPONSIBILITY

Provide planning, organization, actuation, and control of Revenue Cycle Mid-Service functions. Lead the planning, development, and implementation of policies and procedures to support strategic objectives for the management of Outpatient Facility and Professional (OP Facility/Professional) Coding services. Direct all activities related to vendor management of assigned units. Lead operational units and manage resources to meet departmental goals and objectives. Work with operational, clinical, and executive stakeholders to create value, reduce waste, and support the mission of Michigan Medicine.

Provide leadership and direction of all OP Facility/Professional coding operations. Create partnerships with clinical and executive stakeholders to foster an understanding of coding, clinical documentation, and charge capture. Partner with clinical and information technology (IT) resources to improve data capture in the electronic health record (EHR) to facilitate accurate coding. Oversee the collection of meaningful and timely unit metrics in order to make decisions and effect change. Direct improvement efforts to ensure accurate and compliant ICD-10 and CPT code, modifier, and other assignments. Direct improvement efforts to build efficient and effective workflows for OP Facility/Professional Coding. Oversee and enhance a robust OP Facility/Professional coding program focusing on the appropriate capture of information critical for appropriate hospital and professional reimbursement, performance measurement, and benchmarking.

Provide leadership for administrative support staff. Provide leadership for departmental programs that enhance organizational behavior. Lead special departmental projects.

SPECIFIC DUTIES AND RESPONSIBLITIES

 LEADERSHIP

• Direct and oversee the performance of Michigan Medicine and vendor staff. Recommend and institute actions based upon performance measures to improve customer satisfaction, increase efficiency, and improve quality.
• Interact with and advise clinical, operations, technical, and executive stakeholders on best practices for OP Facility/Professional Coding, secondary quality review, coding training and education, and third party denials and appeals.
• Align efforts for OP Facility/Professional Coding with internal and external customer needs.
• Demonstrate ability to think creatively to resolve challenging operational and project implementation matters.
• Serve as an authoritative source of documentation requirements and other standards related to coding.
• Provide consultation across the organization regarding opportunities to improve EHR documentation to facilitate accurate coding and reporting.
• Implement and evaluate an effective plan for work area change and transition; identify future-driven innovations, new business concepts and practices, and create short and long- range objectives and strategies which are aligned with corporate goals.
• Demonstrate a commitment to personal development and learning and maintain accreditation and technical expertise as appropriate; protect confidential information and ensure departmental processes to protect confidential information; demonstrate behaviors which reflect sound personal and business ethics and integrity; model organizational values.
• Provide leadership and oversight of assigned units to assure efficiency and quality of work performance.
• Lead teams, committees, and special projects as assigned.
• Provide leadership representation on institutional committees as it relates to activities and programs.
• Identify and address change management issues related to the evolution of the Revenue Cycle industry.

PROCESS-EXECUTION-OPERATIONS

• Conduct analyses of clinical documentation to identify opportunities and processes for improvement of completeness and specificity to support accurate and complete diagnosis coding, charge capture, and outcomes measurement comparison.
• Develop and implement ongoing performance measures for OP Facility/Professional Coding accuracy and completeness for use in institutional reporting to senior leadership and to identify operational improvement opportunities.
• Develop and implement ongoing performance measurement processes to assure appropriate coding for ICD-10-CM, CPT, modifier and other data elements to identify and evaluate effectiveness of the clinical documentation improvement efforts.
• Act as a subject matter expert on all areas of responsibility and administrative operations.
• Direct the collection and reporting of data for statistical analysis for assigned areas. Ensure a high degree of accuracy in all reporting.
• Oversee the capture and analysis of data regarding operational performance and quality improvement and control.
• Research various topics regarding Revenue Cycle and prepare reports and presentations.
• Plan, develop, revise, and implement programs, policies, and procedures for assigned units.
• Oversee the creation and modification of unit, departmental, and institutional policies and procedures within the scope of assigned responsibilities.
•  Direct assigned operations and partner with unit leadership as well as other stakeholders to implement changes to work processes as needed.
• Ensure appropriate unit and departmental participation in testing of applications.
• Identify user needs and user workflow modeling.
• Analyze and direct the design of Revenue Cycle-related processes, work, and information flows. Redesign unit workflows to improve patient and provider satisfaction, gain efficiency, decrease cost, and reduce waste. Oversee and direct Revenue Cycle quality improvement activities incorporating Highly Reliable principles and practices.

PEOPLE AND PARTNERS

•  Develop and maintain professional relationships with colleagues and staff within the department, across the organization, and external customers to promote mutual understanding and respect.
• Work within the department, across the organization, and with clinical and senior leadership to meet organizational goals.
•  Design requirements, criteria, and metrics to meet the end users’ needs for analysis and interpretation of health information and statistics for assigned areas of responsibility.
• Represent Revenue Cycle at institutional and policy making level meetings, projects, and activities.
• Demonstrate emotional intelligence in the approach to daily activities and challenges both operating and with personnel.
• Lead operational units and manage departmental resources to meet goals and objectives.

PROBLEM SOLVING

• Think strategically and broadly when identifying issues and developing potential solutions. Utilize sound strategic thinking to determine the most efficient and effective way to achieve desired objectives and in recommending alternative options to situations without precedent.
• Demonstrate consistent use of Lean methodology for problem analysis and improvement.
• Demonstrate ability to manage multiple projects and work in a balanced manner to appropriately manage work load and assignments.
• Anticipate potential areas of concern and initiate tracking procedures.
• Lead multidisciplinary process improvement initiatives focused on identifying root causes and correcting improper or ineffective processes, improving compliance, and enhancing staff competency.

supervision received

overall supervision is provided by the Senior Director of Revenue Cycle Mid-Service. 

SUPERVISION EXERCISED

 Functional and administrative supervision is exercised over OP Facility/Professional Coding leadership and staff and administrative staff.

REQUIRED QUALIFICATIONS

• A Bachelor's degree in Health Information Management or other healthcare-related degree.
• Registration with the American Health Information Management Association as a Registered Health Information Technologist/Administrator (RHIT or RHIA), certification through the American Academy of Professional Coders as a CPC, or comparable combination of educational preparation and experience in managing health information and providing effective leadership.
• A Master's degree in public health, healthcare services administration, business administration, health information management, or an equivalent combination of education and experience.
• Demonstrated customer focus and the knowledge and skill to identify, meet, and evaluate customer expectations. Broad customer service experience with patients, families, physicians, and executive leadership.
•  Five to ten years of progressively more responsible leadership experience in Revenue Cycle, Health Information Management, or healthcare operations within a large, fast-paced, and complex health care organization.
• Thorough knowledge and understanding of how health information is used throughout the organization for patient care, reimbursement, statistical analysis, research, and as the legal record.
• Experience in project leadership in a large healthcare organization and an understanding of project management concepts.
• Knowledge of and competence in ICD-10 and CPT coding.
• Skill and experience with influencing and facilitating clinician behavior change.
• Demonstrated leadership skills and significant training in leadership as well as considerable knowledge of modern management and High Reliability principles, practices, and methods.
• Considerable experience and competence in leading institutional committees, conducting formal presentations, identifying the need for and leading institutional and cultural change.
• Executive presence and experience that begets respect.
• Exceptional ability to lead, manage, and mentor staff through complex work redesign efforts.
•  Logical, analytical, and organized with the ability to direct and reprioritize work quickly and efficiently.
• Ability to work in a fast-paced environment under multiple pressures and deadlines.
• Excellent verbal and written communication skills up, down, and across the organization.
• Knowledge of third party payer, regulatory, and accreditation requirements.
• Current membership in the AHIMA and/or AAPC.
• Considerable experience with Windows computer environment and proficiency with Microsoft Office applications.
• Excellent organizational, management, planning, interpersonal, written and oral communication skills.
• Experience in analysis of operations and re-design to improve quality and outcomes.
• Experience and expertise in working with medical staff and medical staff leadership on documentation improvement opportunities.

DESIRED QUALIFICATIONS

• Experience providing project leadership for large Revenue Cycle, financial, operations improvement, or regulatory projects.
• Project Management certification.
• Knowledge of University and departmental policies and procedures.
• Experience with Epic EHR applications.