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Director HIM Coding

Job ID 114550 Date Posted 11/15/2021
San Diego, California
  • Sharp HealthCare
  • System Health Information Mgmt
  • Day Job
  • Full-Time
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Responsibilities

Director of Health Information Coding – Sharp HealthCare

Summary:

The Director, Health Information Management (HIM) Coding embodies Sharp Healthcare's HIM Vision to develop, operationalize, and monitor best practice coding teams and processes in a complete, compliant, and timely coded and abstracted patient medical record for use in the submission of claims, regulatory and quality data, clinical outcomes, population health trending, and ultimately the historical codified record to support the delivery of safe and effective patient care.

The Director, Health Information Management (HIM) coding provides administrative oversight of all coding and abstracting policies and procedures. The Director manages the planning, operational direction, coordination and administration of coding and Clinical Documentation Improvement (CDI) training, abstraction, data review and submission based on The Official Coding Guidelines from the Cooperating Parties; in addition to payor and regulatory agency requirements, applies industry standards and best practices in coding and abstraction to accurately reflect the medical condition and care provided in the patient's record. Recommends and consults with clinical documentation improvement, revenue cycle, compliance, quality and operating entity leadership regarding strategic priorities, and coding outcomes; and directs the preparation and submission of coded and abstracted data to regulatory agencies, including OSHPD. Develops and implements policies and procedures consistent with compliance and privacy regulations, clinical documentation and physician queries. Ensures organizational performance is in alignment with the overall high reliability objectives of the Sharp HealthCare. Defines short term and long-term coding goals and develops and implements action plans to achieve. Acts as liaison with SHC legal counsel for compliance with regulatory statutes. Provides expertise to entity management teams and provides recommendations and consultative guidance and direction in the development of coding and abstracting programs to meet internal and external customer needs.

Required Skills and Qualifications:

  • Minimum of five (5) years of management experience in a large multi-campus acute care facility, focusing on health information management general operations and coding support.           
  • Minimum of ten (10) years of Coding Technician experience in an acute care facility.      

Education: 

  • Bachelor's Degree required; Master's Degree preferred.

Certifications:

  • Certified Coding Specialist (CCS) required.
  • AHIMA Approved ICD-10CM/PCS Trainer required.
  • Registered Health Information Technician (RHIT) and/or Registered Health Information Administrator (RHIA) required.

Key Responsibilities/Essential Functions

 

Coding Management

  • Directs, monitors, evaluates and trends all operational and technical activities for coding and abstracting operations.
  • Develops coding, query and abstraction policies and procedures to meet regulatory requirements, standardized across the hospitals, and implements best practices to achieve optimum coding quality.
  • Directs and manages outsourced coding vendor relationship, monitors and reports on coding turnaround, and accuracy.
  • Collaborates in the review of and response to prepayment and post payment payer and regulatory agency coding and DRG based audits.
  • Oversees system-wide education programs for coding and CDI training.
  • Stays current with changes in the Official Coding Guidelines, and other payer based mandates and acts as a resource for all aspects of coding, education and abstracting practices and technology
  • Chairs coding and clinical documentation committees as established at each entity.

Staff Management

  • Directs the hiring, evaluation and overall supervision of coding and outsourced vendor services.
  • Manages direct reports to assure competency, consistency, and equity within the coding department by establishing goals, assigning responsibilities, and reviewing accomplishments.

Information Management

  • Reviews existing procedures and workflows to continually improve efficiencies to meet organization goals and standards.
  • Ensures the security of protected health information for all electronic and paper-based records.
  • Prepares accurate and meaningful administrative and clinical statistical reports.

Financial Performance

  • Establishes daily, weekly, and monthly key performance indicators and goals aligned with system goals. Monitors goal achievement and implements action plans to maintain performance.
  • Develops department budget and ensures that department operates within confines of established budget.
  • Develops and enforces production standards for each position and communicates individual and team production performance on a regular basis.
  • Develops and monitors system goals for hospital coding discharged not final billed (DNFB) aligned with revenue cycle key performance indicators.
  • Evaluates claims denials and Interfaces with appropriate revenue cycle staff for record submission, coding and billing changes and other pertinent issues.

Customer Service

  • Promotes and maintains positive working relationships within system and entity-based teams, HIM leadership, clinical documentation improvement specialists, and with other departments providing consultation and collaboration on coding initiatives and issues.
  • Develops alliances with the physicians to educate them on documentation and data requirements, and query issues and opportunities.

Skills, Knowledge and Abilities:

  • Thorough knowledge of various reimbursement methodologies including but not limited to Inpatient and Outpatient Prospective Payment.
  • Must be computer literate.
  • Thorough understanding of HIM regulatory and coding practices, official coding guidelines and federal regulations.
  • Demonstrated effectiveness in improving HIM operational efficiency and providing appropriate information to customers.
  • Proficient in use of ICD-10CM and CPT coding conventions, DRG assignment, and APC sequencing.
  • Knowledge of regulatory requirements for Title XXII, TJC and OSHPD, OIG Medicare and Medi-Cal as pertinent to coding and medical record documentation.
  • Strong verbal and written presentation skills with the ability to communicate in a clear, organized manner.
  • Excellent organizational skills and detail oriented.
  • Experienced in managing initiatives with quality improvement techniques.
  • Ability to perceive, design, implement and monitor projects from inception to completion.

 

Compensation and Benefits:

The position provides a very competitive compensation, including opportunity to participate in a management bonus incentive program along with a generous benefit package.

 

About Sharp HealthCare ~

Sharp HealthCare is a not-for-profit integrated regional health care delivery system based in San Diego, California. Sharp includes four acute care hospitals, three specialty hospitals, two affiliated medical groups, a health plan, plus a full spectrum of other facilities and services. Serving a population of approximately 3 million in San Diego County, Sharp has more than 19,000 employees and 3,000 affiliated physicians on medical staffs and operates 1,850 beds.

Sharp HealthCare has been named to Forbes magazine’s second annual list of America’s Best Employers for Women. Sharp was ranked number 58 overall, and was the only San Diego health system included in the list of 300 American companies with at least 1,000 employees. Sharp HealthCare was ranked one of the best employers for diversity on Forbes America's Best Employers for Diversity 2019 list.

In addition to the workplace honors, Sharp was named a 2018 World’s Most Ethical Company by the Ethisphere Institute for the fifth time in six years.

The Sharp Experience is our unique, system wide commitment to transforming the health care experience in San Diego by becoming the best place to work, practice medicine and receive care.

Sharp HealthCare Awards and Recognitions

Sharp HealthCare Benefits

 

Please note: Unsolicited resumes from employment agencies or other third parties will not be considered.

 

“Sharp HealthCare is an Equal Opportunity/Affirmative Action Employer, we celebrate our employees’ differences.  All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, disability, gender, gender identity, transgender status, sexual orientation, protected veteran status, among other things, or status as a qualified individual with disability.

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