The Director of Coding Compliance and Education is responsible for ensuring that healthcare providers, hospitals, and other medical facilities are following all coding regulations, policies, and procedures. This includes managing the training and education of coders, physicians, other healthcare providers and billing staff on clinical documentation improvement and coding best practices; along with reviewing medical records and coding documentation for accuracy and ensuring that billing practices are in accordance with federal and state laws. They may also collaborate with other departments and stakeholders to identify areas for improvement and implement best practices for coding and billing. Overall, the Director of Coding Compliance and Education plays a critical role in ensuring that medical billing and coding practices are accurate, efficient, and in compliance with regulatory requirements, ultimately contributing to improved patient care and financial sustainability of the organization.
- Bachelor’s degree in a related field and/or the equivalent combination of training, education, and experience, required
- 5+ years’ experience Revenue Cycle Management
- 10+ years’ of leadership/training experience required
- Experience with multiple practice management systems
- Expert level knowledge of Microsoft Office (Word and Excel)
- Able to analyze data, identify trends, make recommendations, and provide sound business reason to implement changes
- Excellent written and verbal communication skills
- An innate desire for continuous operational improvement
- Certified coding certificate from AAPC or AHIMA, required
- Knowledge of risk management and HIMS experience
- Progressive experience working with medical staff leadership and senior management
- Conducts regular audits of coding and billing practices to ensure that they comply with regulations, identify areas for improvement, and provide training and support to staff members as necessary.
- Analyzes coding data to identify trends and patterns in coding practices, billing patterns, and potential compliance issues. They also use data to develop strategies to improve coding and billing practices and reduce errors.
- Stays up to date with changes in coding regulations, policies, and procedures to ensure that the organization is always in compliance.
- Designs, develops, and implements coding education programs for clients and staff members in the organization.
- Provide education and training to coding staff, physicians, and other healthcare providers on CDI and coding best practices, including documentation requirements, coding guidelines, and compliance with regulatory requirements.
- Act as a liaison between coding staff and providers to facilitate communication and resolve coding-related issues.
- Establishes key metrics and performance indicators, analyzes operating results, taking adequate steps to correct shortfalls in performance.
- Assures establishment of recruiting, training and development programs, performance management and reward systems to attain the highest level of productivity for long-range success; systems to include provisions to meet all government laws and regulations.
- Responsible for managing elevated client expectations and proactively understanding client issues that may have an impact on success.
- Responds to escalated issues and works to resolve issues appropriately
- Collaborate cross functionally within the organization to ensure consistent client service levels are met.
- Lead the development and documentation of processes and workflows as assigned.
- Responsible for obtaining monthly performance metrics; adhering to all policies and procedures, within the most stringent attention to complying with all governmental and HIPAA mandated patient.
- Account for internal control responsibilities in line with the organization’s objectives.
- Ability to handle Protected Health Information in a manner consistent with the Health Insurance Portability and Accountability Act (HIPAA)
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