DIR CODING & REV INTEG - ACC

Who We AreJPS Health Network is a $950 million, tax-supported healthcare system in North Texas. Licensed for 582 beds, the network features over 25 locations across Tarrant County, with John Peter Smith Hospital -home to Tarrant County's first and only Level I Trauma Center, only psychiatric emergency center, and the largest hospital-based family medical residency program in the nation. The health network employs more than 7,200 people.

Acclaim Multispecialty Group is the medical practice group featuring over 300 providers serving JPS Health Network. Specialties range from primary care to general surgery and trauma. The Acclaim Multispecialty Group formed around a common set of incentives and expectations supporting the operational, financial, and clinical performance
outcomes of the network. Our goal is to provide high quality, compassionate clinical care for every patient, every time.

Why JPS?We're more than a hospital. We're 7,200 of the most dedicated people you could ever meet. Our goal is to make sure the people of our community get the care they need and deserve. As community stewards, we abide by three Rules of the Road :

1. Own it. Everyone who wears the JPS badge contributes to our journey to excellence.
2. Seek joy. Every day, every shift, we celebrate our patients, smile, and emphasize positivity.
3. Don't be a jerk. Everyone is treated with courtesy and respect. Smiling, laughter, compassion - key components of our everyday experience at JPS.

When working here, you're surrounded by passion, diversity, and dedication. We look forward to meeting you!

For more information, visit www.jpshealthnet.org.
To view all job vacancies, visit www.jpshealthnet.org, www.jpshealthnet.org/careers, or www.teamacclaim.org.

Job Title:

DIR CODING & REV INTEG - ACC

Requisition Number:

26822

Employment Type:

Full Time

Division:

Acclaim Administration

Compensation Type:

Salaried

Job Category:

Director / Management Level

Hours Worked:

Location:

South Campus Health Center

Shift Worked:

Job Description:

Description: The Director of Coding and Revenue Integrity provides operational leadership for charge capture, CPT, and ICD coding and coding education for Acclaim Multi-Specialty Group. This position ensures the coding of professional services meet all required regulatory and compliance guidelines. The Director of Coding and Revenue Integrity is responsible for providing oversight of all Acclaim Multi-Specialty Group credentialing and verification-related functions in accordance with Credentialing Verification Services (CVS).
Typical Duties:

1. Ensures department staff is managed effectively, including hiring, scheduling, training, evaluating performance and competency, and conducting disciplinary/counseling sessions as needed
2. Responsible for developing departmental budgets, fiscal accountability, and achieving financial goals/results
3. Develop a robust coding education and auditing program for physicians, allied health, and other practitioners within Acclaim Multi-Specialty Group
4. Oversees the education follow-up for Coding reviews and oversees coding audits for revenue optimization
5. Oversees the implementation of Optum360, Computer Assisted Coding Program, including supervising the cleanup of coding work queues and ensuring successful training for end users
6. Oversees the successful roll-out of CMS-mandated split share billing practices
7. Partners with the VP of Clinical Programs to roll out a successful HCC capture and education program
8. Serves as a point of contact for payer coding audits and training to providers for improvements
9. Directs the development and maintenance of charge review and claim edit work queues
10. Provides leadership to coding and provider education staff, who liaise with medical service providers to resolve issues while maintaining positive relationships with provider practices
11. Builds and maintains positive relationships with external payers
12. Serves as a key point of contact regarding education or coding issues with practice leadership, revenue management, and Professional Billing personnel
13. Develops and provides oversight of the CVS function and effective marketing of its services, as appropriate
14. Administers the medical and legal aspects of credentialing and verification for the Acclaim Multi-Specialty Group
15. Serves as an essential link between senior management of provider organizations in both the facility and physician practice environments
16. In partnership with Acclaim Leadership, manages and prepares for regulatory, NCQA, CMS, and client health plan audits
17. Manages delegated credentialing contracts, from contract review to site visits and audits
18. Supports physician and hospital credentialing needs and requirements
19. Supports managed care payor, hospital, & provider credentialing needs and requirements
20. Assures appropriate level of understanding, awareness, and compliance with all applicable CMS, state and local agency laws, policies and procedures
21. Prepares key management and operational reports for internal and external customers that drive business
22. Performs other job duties as required by the department

Qualifications:

Required Education and Experience:
• Master's Degree in a relevant field
• Five years of experience with medical professional billing
• Five years of related management experience in a supervisory role managing hospital and/or physician credentialing and/or coding
• Five years of work experience with CPT and ICD coding
• Previous work experience relating to provider coding, education, compliance, HCC requirements, reimbursement requirements, and regulatory compliance matters

Required Licensure/Certification/Specialized Training:
• Certified Professional Medical Services Management (CPMSM) Certification
OR
• Certified Professional Credentialing Specialist (CPCS) Certification
OR
• Certified Coding Specialist - Physician-based (CCS-P)
OR
• Equivalent Coding Certification

Preferred Licensure/Certification/Specialized Training:
• Certified Joint Commission Program (CJCP) Certification
• Medical Terminology Certification

Location Address:
2500 Circle Drive
Fort Worth, Texas, 76119
United States