Under the direction of the System HIM Director, the HIM Coding Director is responsible for planning, managing, leading, and implementing the coding activities of the Health Information Management Department (HIM) and campus specific initiatives. Coordinates and develops department policies, functions, goals and objectives. Leadership is demonstrated through collaboration, communication, change management, and strategic business decision-making. Through effective leadership, produce sustainable results while creating an engaging atmosphere in which all employees contribute to the success of the team. Maintains and promotes the confidentiality of employees, patients, administrative staff and functions, and medical staff information with no infractions. Adheres to the AdventHealth corporate compliance plan and to all rules and regulations of applicable local, state, federal agencies and accrediting bodies governing the practice of Health information. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
Resignation Notice: A six week notice is required for resignation, as well any change in employment status resulting in decreased hours worked.
KNOWLEDGE AND SKILLS REQUIRED: Knowledge of Medicare reimbursement systems, data abstraction and encoder functionality. Comprehensive knowledge of coding functions, rules and guidelines as it relates to Current Procedural Terminology (CPT) or Diagnosis Related Groups (DRG) assignment. Ambulatory Patient Classification (APC), coding guidelines and reimbursement systems. Extensive knowledge of charge capture, coding requirements and clinical implications, information systems, analytical and planning skills. Critical thinking and problem-solving skills, self-motivation, self-confidence and adaptability. Success as a leader with strong organizational, team development, and mentoring skills. Ability to lead and direct employees and other members of the hospital leadership team and demonstrate professionalism by establishing and main
SCOPE OF RESPONSIBILITY:
· Directs, administers and continually improves patient revenue cycle outcomes in terms of coding and clinical data abstraction functions. Serves as liaison to closely align with and educate the revenue cycle operations on best practices related to coding.
· Collaboratively and professionally work with all revenue cycle departments and system wide departments such as Clinical Documentation Integrity, Utilization Management, Nursing, Medical Staff, Surgical Services, Emergency Department, Ambulatory Care Services, Performance Improvement, and Information Systems to support regulatory and compliance efforts.
· Serves as the hospital subject matter expert for knowledge and understanding of coding conventions and acts as resource for interpretation of coding guidelines/specifications.
· Ensures accurate and timely coding of inpatient and outpatient records according to CMS standards, coding conventions and guidelines. Consistently meets and or exceeds internal departmental targets.
· Maintains and expands development of coding statistics and scorecard reports in order to benchmark results for improved efficiency and effectiveness of the revenue cycle. Continuously measures resources and deliverables for purposes of process improvements initiatives.
· Oversees internal and external coding audits to identify areas in need of improvement or potential risk to the organization. Responsible for implementing and monitoring recommendations.
· Identifies root causes resulting in deficiencies and directs/facilitates the development of corrective action plans.
· Educate on quality issues related to clinical documentation with effective communication to clinical areas in support of error reduction.
· Maintains and revises all policies and procedures related to coding ensuring alignment with system wide policies while providing education and communication regarding changes. Ensure all policies are consistent with current federal, state and accrediting body requirements.
· Takes the initiative to keep the HIM System Director informed of any problematic issues relating to areas of responsibility.
· Maintains professional and cohesive relationships with administration, medical staff, nursing, and all other ancillary and support departments.
· Leads and mentors other credentialed professionals to establish and ensure solid succession plans, while affording individuals professional development and opportunities.
· Promotes and protects confidentiality, integrity, and security of health information.
· Strives for professional excellence through self-assessment, continuing education, and maintenance of credentialed status.
· Recruits professional and qualified individuals in ongoing support of the coding/HIM profession.
· Maintains working knowledge of state and national coding issues effecting coding, physicians and overall organization related to reimbursement and/or compliance guidelines.
· Facilitate system wide compliance with regulation requirements set forth by CMS, AHCA, Det Norske Veritas (DNV), HIPAA, and other state and federal legislation accreditation, legal and compliance requirements in regard to coding and clinical data management.
· Demonstrates commitment to AHIMA’s Standards of Ethical Coding through integrity and sound, ethical decision-making processes.
OPERATING & CAPITAL BUDGET/FINANCIAL RESPONSIBILITY:
· Responsible for leadership and oversight of an annual operating budget of $9.4 million.
· Collaborates with fellow directors regarding department budget and operational plan development to maintain fiduciary responsibility and achieve greater financial performance.
· Provide feedback and insight regarding annual capital needs for area of responsibility.
· Manage department labor tracking and budget in accordance with organizational policies and in conjunction with HIM System Director.
· Participates in strategic financial planning with HIM System Director and Revenue Cycle leadership.
STRATEGIC PLANNING RESPONSIBILITY:
· As a member of the hospital leadership, contribute to the development and implementation of the strategic innovation agenda. Ensures strong leadership representation at committee meetings.
· Collaborate with HIM and revenue cycle leaders in developing short and long term strategic plans to ensure continued success and sustainability while considering new opportunities to advance coding and the revenue cycle to pacesetting performance.
PERFORMANCE IMPROVEMENT RESPONSIBILITY:
· Cultivate department and revenue cycle compliance through collaborative efforts with key departments and their leadership to include development and deployment of department and hospital wide education and process change initiatives.
· Develop and implement department and hospital wide initiatives and education in support of patient safety and compliance improvement. Activity to include presentations at medical staff and nursing leadership meetings, development of education and communication materials.
· Contributes to patient safety and quality of care in accordance with the mission and strategic goals of the department and AdventHealth. Develops and implements key performance measures such as retained, coding turn-around time, quality, productivity, etc.
COMMUNITY RELATIONS RESPONSIBILITY:
· Supports, promotes, and encourages AdventHealth community efforts such as canned food drive, Backpack for Kids, Adopt-a-Family, United Way, and all other related activities.
· Actively participates and supports national, state and local professional associations.
· Serve as coding department preceptor for accredited education programs creating an opportunity for professional development through education, mentoring and attraction of effective management and team members.
· Responsible for recruiting and providing support, guidance and mentorship to the coding team to ensure succession planning.
· Manages the work of a Coding Senior Manager, multiple coding managers and supervisors who are directly responsible for and supports a total of 115 FTE’s.
· Provides leadership and guidance of staffing resources to ensure compliance with department standards. Ensures flex hours as needed.
What You Will Need:
Associate’s or Bachelor’s degree in Health Information Management or related health care field with a focus on HIM or
Level of experience and knowledge equivalent to a Bachelor’s degree in Health Information Management
Education must provide eligibility for RHIA credential exam as required by the American Health Information Management Association (AHIMA)
RN with coding experience
Minimum 10 years of coding management experience
Minimum 5 years of inpatient and outpatient coding experience in an acute care hospital
Minimum 3 years of experience with comprehensive cases requiring a more complex level of coding
Experience with healthcare quality/performance/process improvement
LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED
Certified Coding Specialist (CCS) designation
Licensure, Certification, or Registration Preferred:
ICD-10-CM/PCS AHIMA approved Trainer
Registered Health Information Administrator (RHIA)
How we treat those we serve and each other is what sets us apart from other healthcare organizations. We want everyone who walks through our doors to feel loved, cared for, and at ease. Whether you are clinical or non-clinical, your actions and behaviors can create an environment that either builds trust or causes anxiety and fear. We have made it easy for you to ensure that you are always building trust and providing excellent care by exhibiting our Service Standards.
All team members will be held accountable forconsistently living out our 16 Service Standards and the additional behaviors listed below to ensure that every person, every time has an exceptional experience.
KEEP ME SAFE
I make safety my number one priority.
I protect privacy and confidentiality.
I keep my environment clean.
I follow the dress code and wear my badge correctly.
I treat others with uncommon compassion.
I nurture whole-person care through CREATION Health.
I treat others with fairness and respect.
I listen and communicate using iCARE. (Introduce, Connect, Anticipate, Reinforce, Extend)
MAKE IT EASY
I help guests to their destination.
I speak highly of others to provide connected care.
I collaborate to create solutions, not excuses.
I innovate and continually seek ways to improve our work.
I am positive and aim to exceed all expectations.
I follow through on commitments.
I use discretion with personal devices.
I recover service and restore trust using ACT. (Acknowledge/Apologize, Correct, Thank)
Team members must conform to all AdventHealth organizational and departmental policies and procedures including but not limited to:
· Code of Conduct as outlined in the “Guidelines for Employees” handbook
Establishes and maintains a history of regular attendance; makes appropriate use of PDO and observes department call-in procedures for absence; establishes and maintains punctual work habits. Exhibits timely arrival and departure and dependable time habits including meal and other breaks.
Attends and participates in mandatory facility-wide and department training/meetings as required (including but not limited to: ALN, safety training, etc.). Is able to demonstrate and apply knowledge of fire, safety, security, and disaster procedure regulations as presented in orientation, outlined in the safety manual, and as pertains to each work area.
Required to respond to emergency situations (i.e. disasters, hurricanes, etc.) by reporting to department and staying until the crisis is over or your position is covered by incoming personnel. This is a mandatory requirement. Refusal to respond may result in termination.
Contributes to the successful achievement of department-stated goals and objectives and will facilitate staff cohesiveness and communication.
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.