Director of Technical Coding Services - Remote

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Job Title

Director of Technical Coding Services - Remote

Location

Cleveland

Facility

Remote Location

Department

CCHS Him Admin-Finance

Job Code

T99720

Shift

Days

Schedule

7:00am-5:00pm

Job Summary

Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as the No. 4 hospital in the nation, according to the U.S. News & World Report. At Cleveland Clinic, you will work alongside passionate and dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.

As a Director of Coding and Reimbursement, you will: • Direct the vision, strategy and operations of Technical Coding Services, Audit, Education and/or Denials across the Cleveland Clinic enterprise. • Ensure accurate and compliant coding and charge capture for acute care, ambulatory offices, and/or physician offices accordingly and partners with Clinical Documentation Integrity (CDI) on accurate documentation. • Serve as a liaison to various departments, physicians, and allied health professionals regarding technical and/or professional coding issues and questions. • Collaborate with other revenue cycle and clinical leaders to execute enterprise-wide initiatives and support organizational goals.

At Cleveland Clinic, we know what matters most. That's why we treat our caregivers as if they are our own family, and we are always creating ways to be there for you. Here, you'll find that we offer: resources to learn and grow, a fulfilling career for everyone, and comprehensive benefits that invest in your health, your physical and mental well-being and your future. When you join Cleveland Clinic, you'll be part of a supportive caregiver family that will be united in shared values and purpose to fulfill our promise of being the best place to receive care and the best place to work in healthcare.

Strongly prefer the following: • Advanced knowledge of coding classification and reimbursement systems to include, but not limited to ICD-10-CM/PCS, CPT (I/II/III), HCPCS Level II, MS-DRGs, APR-DRGs, IRF PPS, IPF PPS, APC• Advanced knowledge of patient safety indicators (PSIs), hospital acquired conditions (HACs), diagnoses present on admission (POA), and risk adjustment models - CMS, Vizient, USNWR, CMS-HCCs• Epic Resolute, 3M 360 Encompass, and computer assisted coding (CAC) experience

Job Details

Responsibilities:

• Establishes and drives strategy, execution of initiatives, program goals and objectives, monitors performance, issues and risks, and promotes data integrity and best outcomes for all lines of the enterprise in Technical Coding Services, Audit, Education, and/or Denials.
• Routinely collaborates with Clinical Documentation Improvement (CDI) work group on accurate documentation and coding to improve quality outcomes and foster accurate reimbursement (i.e. patient safety indicators (PSIs), hospital acquired conditions (HACs), diagnoses present on admission (POA), complications and comorbid conditions, risk adjustment models - CMS, Vizient, USNWR, etc, clarification queries, and education).
• Develops and maintains standardized practices, processes, metrics, policies and procedures and guidelines across the enterprise to reduce front-end issues and ensure accurate reimbursement and patient satisfaction.
• Serves as liaison to Institutes and Market leaders regarding technical and/or professional coding, reimbursement, and customer service related issues.
• Develops training programs for coders, medical staff and ancillary personnel as related to coding and documentation in alignment with regulatory requirements and reimbursement and other patient service issues. Develops management reporting systems to ensure accurate and timely reporting of goals and results.
• Oversees and monitors resolution of patient and insurance inquiries as well as the coding compliance program enterprise-wide to include conducting and overseeing coding audit efforts, reports non-compliance issues detected, collaborates with key stakeholders on action plans, and results of follow-up audits.
• Monitors changes in regulatory coding, monitor's compliance with documentation guidelines and testing compliance with regulations.
• Directs technology optimization and automation solution initiatives to include initiating, evaluating, and implementing in collaboration with ITD, providers, and other success partners.
• Promotes and helps maintain a professional team-oriented, service-conscious culture that contributes to the goals of the department and organization and reflects the values of the system.
• Other duties as assigned.

Education:

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

Languages:

• English required

Certifications:

• Registered Health Information Administrator certification (RHIA), Registered Health Information Technician certification (RHIT), Certified Coding Specialist (CCS) or Certified Professional Coder certification (CPC) through the American Health Information Management Association is required

Complexity of Work:

• Within the scope of the job, requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.
• Must be able to work in a stressful environment.
• Excellent problem-solver with a talent for synthesizing complex projects and translating high-level goals into actionable plans.
• Advanced skills in Microsoft Office or Client 365 and MS Teams.
• Demonstrated team, leadership, organizational, financial management and problem solving skills.
• Excellent verbal and written communication, negotiation, and collaboration skills.

Work Experience:

• Minimum of 8 years of functionally relevant experience required.
• Offset: High School Diploma / GED or equivalent and 13 years of progressively responsible experience.

Physical Requirements:

• Ability to communicate and exchange accurate information.
• Ability to perform work in a stationary position for extended periods.
• Ability to work with physical records or operate a computer or other office equipment.
• In some locations, ability to travel throughout the hospital system.
• In some locations ability to move up to 25 lbs.

Personal Protective Equipment:

• Follows standard precautions using personal protective equipment (PPE) as required.

The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our employees and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. Job offers will be rescinded for candidates for employment who test positive for nicotine. Candidates for employment who are impacted by Cleveland Clinic Health System's Smoking Policy will be permitted to reapply for open positions after 90 days.

Cleveland Clinic Health System administers an influenza prevention program as well as a COVID-19 vaccine program. You will be required to comply with both programs, which will include obtaining an influenza vaccination on an annual basis, and being fully vaccinated against COVID-19, or obtaining an approved exemption.

Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility.

Please review the Equal Employment Opportunity poster.

Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities