The coding department is responsible for procedure and diagnostic coding for professional services in multiple specialties as well as reviewing commercial and Medicare denials regarding coding related issues. In addition, this department includes a national Health Information Management hospital coding audit team. The Vice President of HIM oversees all department operations, staffing, training and compliance. This leadership position will provide vision and direction, and balance the client expectations/team performance through effective communication and organized process improvement initiatives. Further, the Vice President of HIM will participate in executive team and client meetings.
ESSENTIAL DUTIES and RESPONSIBILITIES:
EDUCATION and EXPERIENCE:
- Direct remote compliance and coding teams to meet stated contractual productivity metrics.
- Oversee Director and Executive Director level employees to ensure coordination of all department staff needs and management of coding staff in SPi Healthcare office locations and remote staff; including staff hiring, evaluation, development and workflow management.
- Identify and develop additional service offerings where applicable.
- Identify and direct vendor partnership relationships to optimize and expand services for our Professional Coding and HIM teams
- Ensure team is meeting contractual agreements and exceeding client service expectations.
- Oversees the planning of resource schedules and communication of audit schedules to clients.
- Participate in continuing education activities as well as plan/instruct/present coding issues and topics to coding staff.
- Design workflow processes to ensure efficiency, quality of work and client service levels are met
- Analyze coding patterns of physicians to identify potential compliance risks, recommend solutions and monitor improvements.
- Assist operations staff with payer denials, government requests, patient inquiries related to coding or billing issues, and makes coding decisions on claim appeals for payment.
- Develop and manage process to review/audit coded records and maintain quality assurance.
- Monitor the coding compliance activities and plan.
- Participate in executive team and client meetings.
- Other duties and special projects as needed.
- 15+ years experience in a healthcare organization
- 7+ years experience in a leadership role, with experience managing multiple teams across multiple departments
- Effective leadership experience in managing remote teams with sharing vision and motivation
- Solid understanding of hospital HIM and professional services revenue cycle operations
- Excellent verbal and written communication skills and experience with executive level business interaction
- CPC, CCS-P, or RHIA/RHIT certification required (may also hold additional or specialty certifications)
- Bachelor’s degree or commensurate experience required
- Ability to communicate clearly and effectively manage a team
- Extensive knowledge on how to problem-solve insurance and denial issues regarding coding
- Thorough understanding of third party reimbursement regulations and billing practices
- Exceptional skill in the areas of medical terminology, human anatomy, and coding
- Ability to effectively present information in one-on-one and small group situations to customers, clients, staff and other employees of the organization
- Ability to travel nationally, as required by the needs of the business (up to 35%).
- Ability to travel internationally, as required by the needs of the business (up to 5%).
SPi Healthcare - 18 months ago
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SPi Healthcare (formerly Springfield Service Corporation and Laguna Medical Systems) is the industry's leading integrated revenue cycle and...