Director, Medical Coding Operations

Job Role Summary

Enjoying your job makes smiling easy. At Eskenazi Health, we care about our employees and want them to have the best experience possible while on the job. Eskenazi Health is always looking for quality professionals to fill positions in the organization.

We are one of America's largest essential health systems.  Our mission is to Advocate, Care, Teach and Serve, with special emphasis on the vulnerable populations of Marion County, Indiana. Our academic health system provides a comprehensive range of primary and specialty care services within our 333-bed hospital and inpatient facilities as well as community health centers located throughout Indianapolis.  We put our patients first, and we provide excellent quality care indiscriminately and without consideration of financial factors.

Eskenazi Health is seeking a Director of Medical Coding Operations to oversee and manage all aspects of medical coding operations within Eskenazi Health, including the Clinical Documentation Improvement Program (CDIP).  The successful candidate needs to have a strong understanding of inpatient and outpatient medical coding practices and guidelines, as well as the ability to lead a team and ensure compliance with industry standards. Expertise in medical coding and billing is essential in ensuring accurate and timely reimbursement for services provided, and the Director of Medical Coding Operations plays a key role in maintaining compliance, improving financial performance, and ultimately supporting the delivery of quality patient care.

Essential Functions and Responsibilities

The Director of Medical Coding Operations is responsible for establishing and maintaining coding policies and procedures in accordance with industry standards and regulations. This includes ensuring compliance with coding guidelines such as ICD-10-CM, CPT, and HCPCS Level II as supported by cooperating regulatory parties (AHIMA, CMS, AHA, AMA, and National Center for Health Statistics). The incumbent will oversee a team of medical coders and nurses, providing guidance and support to ensure accurate and timely coding. This includes assigning work, conducting performance evaluations, and providing necessary training and education to keep the team up to date with coding changes. In addition to maintaining a high level of coding accuracy and ensuring compliance with coding regulations and guidelines. This includes conducting regular audits and reviews to identify and address coding errors, as well as implementing corrective actions when necessary.

• Continuously stay informed of coding changes and updates, as well as industry regulations, to ensure compliance
• Collaborate with other departments within the healthcare facility, such as revenue cycle management, compliance, and clinical areas, to ensure effective communication and coordination of coding processes
• Provide ongoing education and training to healthcare providers, coders, and other relevant staff to ensure they are knowledgeable about coding guidelines and practices. This includes conducting training sessions, creating educational materials, and providing guidance on coding-related queries
• Maintains consistent uncoded (Inpatient and Outpatient) volumes within expected target limits.  Proactively modifies coding and clinical documentation workflow activities to ensure acceptable uncoded volumes and effective clinical documentation review processes
• Maintains contract relationships with outside vendors, including service level agreements, and ongoing negotiations needed in the Coding and CDI areas
• Provides oversight of third-party compliance/audit (i.e. RAC, MIC and QIO) requests and response processes including monitoring the flow of funds and reporting outcomes
• Provides oversight of the Clinical Documentation Improvement Program (CDIP) to ensure accurate and timely clinical documentation in the medical record.  Supports the coding process in attaining appropriate DRG’s based on sound clinical entries in the medical record
• Supports ongoing communication and education on documentation opportunities, coding, and reimbursement issues, as well as performance improvement methodologies to physicians and entire hospital staff
• Tracks CDIP program successes and ongoing opportunities, including dashboard development and communication
• Promotes longevity of the clinical documentation management program; maintains active administration support and where necessary, helps to develop strategies and remove barriers that address resistance to the clinical documentation management functions
• Manages the budget for assigned areas of responsibility
• Maintains a professional, positive working relationship with medical staff and other hospital personnel

Job Requirements

Accredited Bachelor’s in Health Information Administration or related field, with five (5) years of experience in medical coding, preferably varied in an acute care setting, and two (2) years in a leadership or supervisory role; OR seven (7) years’ experience in medical coding, preferably varied in an acute care setting, and three (3) years of supervisory/management experience. Registered Health Information Manager (RHIA), Registered Health Information Technologist (RHIT), Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification required.