Director of Coding

Best Care; Omaha (NE); On-site; USD 90,000 - 130,000; Full time

Job summary

Nebraska Methodist Health System in Omaha seeks an experienced leader to oversee medical coding and billing operations. You will manage a team, ensure accuracy, and maintain compliance with ICD-10-CM, CPT, and HCPCS guidelines.

This role partners with Revenue Cycle, Compliance, and CDI to optimize processes, provide training, monitor denials, and stay current with CMS changes; a Bachelor's in HIM or related field and CCS/CPC/CRC certifications are preferred.

Qualifications

• Bachelor’s degree in Health Information Management or related field or equivalent education/experience required.
• Minimum of 5 years of experience in medical coding, with at least 2 years in a leadership or supervisory role.
• Certification: CCS or CPC required; CRC required; CPMA preferred.
• Extensive knowledge of ICD-10-CM, CPT, and HCPCS Level II; HIPAA and CMS regulations.

Responsibilities

• Establish and maintain coding policies and procedures per industry standards and regulations.
• Oversee a team of medical coders; provide guidance, training, and performance evaluations.
• Maintain high coding accuracy and ensure regulatory compliance through audits and corrective actions.
• Stay informed on coding changes and industry regulations; participate in relevant workshops and conferences.
• Collaborate with Revenue Cycle, Compliance, and CDI to ensure effective communication of coding processes.
• Provide education and training on coding guidelines to providers and staff.
• Oversee MPC billing practices in collaboration with Revenue Cycle, Finance, and Billing.
• Manage staff and analytics related to physician compensation; monitor wRVU and CMS changes.

Skills

Leadership

Coding knowledge

Audits

Compliance

Collaboration

Education/Training

Billing oversight

WRVU/CMS knowledge

Education

Bachelor’s degree in Health Information Management or related field

Tools

Coding software

Electronic Health Records (EHR) systems

Job description

Why work for Nebraska Methodist Health System?
At Nebraska Methodist Health System, we focus on providing exceptional care to the communities we serve and people we employ. We call it The Meaning of Care – a culture that has and will continue to set us apart. It’s helping families grow by making each delivery special, conveying a difficult diagnosis with a compassionate touch, going above and beyond for a patient’s needs, or giving a high five when a patient beats a disease or conquers a personal health challenge. We offer competitive pay, excellent benefits and a great work environment where all employees are valued! Most importantly, our employees are part of a team that makes a real difference in the communities we live and work in.

Job Summary:

Location: Methodist Corporate Office
Address: 825 S 169th St. - Omaha, NE

Work Schedule: Full time, Mon - Fri

Responsible for overseeing and managing all aspects of professional medical coding and billing operations within our healthcare facility. A strong understanding of medical coding practices and guidelines, as well as the ability to lead a team and ensure compliance with industry standards.

Responsibilities:

Essential Job Functions

1. Establish and maintaining coding policies and procedures in accordance with industry standards and regulations. This includes ensuring compliance with coding guidelines such as ICD-10-CM, CPT, and HCPCS Level II.

2. Oversee a team of medical coders and providing guidance and support to ensure accurate and timely coding. This includes assigning work, conducting performance evaluations, and providing necessary training and education to keep the team up to date with coding changes.

3. Maintain a high level of coding accuracy and ensuring compliance with coding regulations and guidelines. This includes conducting regular audits and reviews to identify and address coding errors, as well as implementing corrective actions when necessary.

4. Continuously stay informed of coding changes and updates, as well as industry regulations, to ensure compliance. This includes attending workshops, seminars, and conferences, and staying connected with professional coding organizations.

5. Collaborate with other departments within the healthcare facility, such as revenue cycle management, compliance, and clinical documentation improvement, to ensure effective communication and coordination of coding processes.

6. Provide ongoing education and training to healthcare providers, coders, and other relevant staff to ensure they are knowledgeable about coding guidelines and practices. This includes conducting training sessions, creating educational materials, and providing guidance on coding-related queries.

7. Oversight of all billing practices related to MPC in collaboration with revenue cycle, finance and billing departments for the health system. This will include pricing structures as well as best practice for professional billing. Monitor relevant denial and payer rejection trends for escalation to payers.

8. Oversee staff and analytics related to physician compensation. Stay up to date on change in wRVus and CMS changes related to fee schedules. Responsible for assignment of wRVU value analysis and policies and resolution of provider wRVU inquiries and discrepancies.

Schedule:

Full time, Mon - Fri

Job Description:

Job Requirements

Education

• Bachelor’s degree in Health Information Management or related field OR equivalent combination of education/experience combined (one year of education equals one year of experience) required.

Experience

• Minimum of 5 years of experience in medical coding, with at least 2 years in a leadership or supervisory role required.

License/Certifications

• Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification required.

• Certified Risk Adjustment Coder (CRC) certification required.

• Certified Professional Medical Auditor (CPMA) certification preferred.

Skills/Knowledge/Abilities

• Extensive knowledge of medical coding systems, practices, guidelines and regulations, including ICD-10-CM, CPT, and HCPCS Level II.

• Familiarity with industry coding guidelines and regulations, including HIPAA and CMS regulations.

• Strong leadership and management skills, with the ability to effectively manage a team and drive results.

• Excellent communication and interpersonal skills, with the ability to collaborate with various stakeholders and build strong relationships.

• Detail-oriented and analytical, with the ability to review and analyze coding data and identify areas for improvement.

• Strong understanding of healthcare reimbursement methodologies and payment systems.

• Proficiency in using coding software and electronic health record systems.

• Problem-solving skills, with the ability to identify coding issues and develop solutions to ensure compliance and accuracy.

Physical Requirements

Weight Demands

• Light Work - Exerting up to 20 pounds of force.

Physical Activity

• Not necessary for the position (0%):
• Occasionally Performed (1%-33%):
• Frequently Performed (34%-66%):
• Constantly Performed (67%-100%):

Job Hazards

• Not Related:

About Methodist:

Nebraska Methodist Health System is made up of four hospitals in Nebraska and southwest Iowa, more than 30 clinic locations, a nursing and allied health college, and a medical supply distributorship and central laundry facility. From the day Methodist Hospital was chartered in 1891, service to our communities has been a top priority. Financial assistance, health education, outreach to our diverse communities and populations, and other community benefit activities have always been central to our mission.

Nebraska Methodist Health System is an Affi…