Sr. Corp. Coding Education Spec.

Facility: Ardent Corporate OfficeRequired Education: Not SpecifiedJob Description:
Position SummaryThe Senior Corporate Coding Education Specialist is responsible for the areas set forth in the primary responsibility section. The Senior Coding Specialist possesses requisite managerial and technical abilities to provide facility and corporate leadership in the complete, accurate and compliant application of correct coding principles for hospital inpatient and outpatient based coding to ensure appropriate reimbursement and data integrity. Provides on-going review of patient records and reviews code assignments to determine accuracy of codes for each diagnosis and procedure. The Specialist also provides education and creates education materials for facility-based coding staff and medical staff on appropriate code selection and appropriate documentation principles to provide supporting medical record documentation. In addition, the Specialist will participate in developing and implementing:
Programs for coding compliance monitoring,
Criteria for benchmark comparisons,
Developing corporate policies and procedures,
Corporate coding education program development and deployment,
Physician clinical documentation improvement programs,
Denial management programs,
Staffing needs assessments,
New employee training and orientation, and
Coding compliance software technology implementation.Responsible for administrative duties related to planning, scheduling, and conducting coding audits at Ardent owned facilities; writing assessment reports for facilities and corporate, cooperating with Compliance, Internal Audit, and other departments on special audits/inquiries involving coding/billing questions; and potentially providing guidance through Corporate HIM/ Coding Help Line, and Quality Control mechanisms.This position works directly within the corporate and hospital-based structure with Legal Counsel, Health Information Management, Information Technology, Compliance/Internal Audit, and Patient Financial Services. This position also has collaborative work relationship with Finance and Case Management.
REQUIREMENTS
QualificationsEducation: Undergraduate Degree or equivalent level of higher education in nursing or Health Information Management and appropriate credentials (RHIA, RHIT, RN with Certified Coding Credential, CCS, CPC and/or CCS-P).Professional Distinction: Must be in good standing with credentialing board(s) and credentials must be in Active Status (current on all continuing education, etc.)
Experience: 5+ years coding/abstracting experience in ICD-9-CM, CPT-4, HCPCS, DRGs, APCs, and modifiers and 2+ years chart review/audit consulting or corporate based type experience. Related industry experience (Med-Surg).
Additional Requirements: Proven effective organizational, communication skills (written and verbal), ability to multi-task, effective organization skills, decision-making ability, initiative, adaptability, customer focus and ability to complete assignments timely. Must have a thorough knowledge of hospital operations, health information management and coding compliance.Additional Requirements:
Ability and willingness to travel 40-75 % on the average.PRIMARY RESPONSIBILITIES1. Ensure Corporate Coding Program goals and objectives through coding accuracy and compliance reviews are reached.
2. Plan and perform coding reviews across all types of Ardent Health Services facilities; hospitals, home health agencies, skilled nursing, and rehabilitation, based upon coding specialty level and expertise.
3. Develop and revise coding review and education methodology and programs/products as needed to be current and prepare coding assessment reports and work papers.
4. Accountability for all phases of record review, identifying areas for improvement, and analytical/statistical reports of coding review data.
5. Develops and implements corporate coding compliance function policies, guidelines, procedures, and standards.
6. Provides education and creates education materials for facility-based coding staff and medical staff on appropriate code selection and appropriate documentation principles to provide supporting medical record documentation.
7. Participate in developing and implementing:
Programs for coding compliance monitoring,
Criteria for benchmark comparisons,
Developing corporate policies and procedures,
Corporate coding education program development and deployment,
Physician clinical documentation improvement programs,
Denial management programs,
Staffing needs assessments,
New employee training and orientation, and
Coding compliance software technology implementation.
8. Participate in interdepartmental/multidisciplinary team meetings, committees and/or task forces at facilities and at corporate level. Facilitate networking of best-demonstrated HIM/ Coding Compliance practices within the company.
9. Maintains discipline based accuracy rates - DRG - 95%, APC - 95%, CPT-4 - 95%, HHRGs - 95%, Physician based - 95%
10. Keep current on changes in coding practices, state and federal regulations and JCAHO requirements with regard to coding areas.
11. Facilitate communication of coding education results to facility based and corporate staff through written and oral presentation.
12. Develops and assists IT initiatives in reviewing, selecting, operationalizing, and monitoring coding compliance software tools for Ardent Health Services.
13. Assists Corporate Coding Managers, HIM Directors, and hospital-based coding professionals in implementation of physician documentation improvement programs to improve physician documentation to support quality of care, case management, and coding/case mix/ service mix index.
14. Perform administrative duties in order to assist management with overall audits and special projects.
15. Assist in other areas of HIM, CDM/ Charge Capture, Case Management, as needed to create best practices among disciplines and/or compliance initiatives.Location of this position can be flexible.Ardent is an EOE.