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Title

Director of Professional Fee Coding 

EOE Statement eCatalyst Healthcare Solutions, Inc. is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.  
Description

Director of Professional Fee Coding

Location: Chicago, IL

Status: Salaried, Exempt 

Job Summary

The Director of Professional Fee Coding oversees our client's Health Information Management (HIM) Professional Fee coding program and serve as a resource to leaders, staff, and physicians on coding and documentation standards and regulations.

Additionally, the Director of Professional Fee Coding will conduct trend analysis, audits, and internal investigations to monitor program compliance and initiates corrective action plans where appropriate. The Director of Professional Fee Coding will represent eCatalyst Healthcare Solutions as a trusted partner daily with the client. 

Essential Functions

Oversees and monitors implementation of the client's HIM Professional Fee medical coding program, including appropriate documentation, accurate coding, and adherence to hospital and regulatory policies and guidelines for all appropriate personnel, including HIM Professional Fee medical coding staff, physicians, billing personnel, and ancillary department support.  

Ensures that coding staff, consultants, and other contracted support adhere to the organization's HIM compliance program. 

Conducts regular audits and coordinates ongoing monitoring of coding and documentation adequacy.   

Serves as a resource for department managers, staff, physicians, and administration to obtain information or clarification on accurate and ethical coding and documentation standards, guidelines, and regulatory requirements.  

Develops and coordinates appropriate training materials, conducts in-services, and ensures the proper dissemination and communication of all regulations, policies, and guideline changes to affected personnel.  

Conducts trend analyses to identify patterns and variations in coding practices and case-mix index. Compares coding and reimbursement profiles with national and regional norms to determine variations requiring further investigation. 

Reviews claim denials and rejections pertaining to coding and medical necessity issues and, when necessary, implements corrective action plans, such as educational programs, to prevent similar denials and rejections from recurring.  

Identifies required enhancements in technology platforms to improve the accuracy and efficiency of coding. Reports non-compliance issues detected through auditing and monitoring, the nature of corrective action plans implemented in response to identified problems, and the results of follow-up audit to the Director of HIM. 

Receives and investigates reports of HIM compliance violations and communicates this information to the Director of HIM.   

Works with the Clinical Documentation Improvement team to address documentation and coding issues. Monitors CMI identifies opportunities related to documentation and coding.   

Provides training to CDI staff regarding coding and MS-DRG assignment. Assists CDI leadership in resolving DRG mismatch cases. Identifies and addresses trends in coding issues related to documentation.      

Participates in hiring, evaluation, and disciplinary action according to client policies and under the client's direction.

 
Position Requirements

Required Certifications

  • CCS, CCS-P, RHIT, or RHIA certification. 
  • Bachelor’s Degree in Health Information Management (HIM) or related field. 
  • 8+ years of hospital or other healthcare services HIM operations management experience. 
  • 5+ years of medical coding experience with demonstrated background in hospital, physician, or other healthcare environment coding and reimbursement. 
  • Knowledge and understanding of HIPAA/HITECH and medical coding compliance.
  • Previous experience leading HIM operations, medical coding, or auditing teams.
  • Proficiency in Electronic Medical Records (EMR) such as EPIC and similar coding software systems. 
  • Demonstrated experience developing and maintaining client relationships.
  • Microsoft Office (Excel, Word, Outlook, Teams) proficiency.
  • Advanced verbal, nonverbal, visual, and written communication skills.

 

EEO Statement

It is the policy of eCatalyst Healthcare Solutions, Inc. to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristic under applicable law. 

Please note this description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required for this job. Duties, responsibilities and activities may change at any time with or without notice. 

 
Full-Time/Part-Time Full-Time  
About the Organization eCatalyst Healthcare Solutions is proud to be one of the nation's top HIM and Middle Revenue Cycle companies. Our expertise includes coding, auditing, clinical documentation improvement (CDI), master patient index, registry, revenue cycle, staffing, consulting, and more. eCatalyst is distinguished by our highly experienced and credentialed team and our unrelenting client focus.  

This position is currently not accepting applications.

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