Director, Reimb/Coding/Charges - Corporate Reimbursement/Coding - Full Time

Guthrie; United States; On-site; USD 85,000 - 120,000; Full time

Job summary

A healthcare organization is seeking a Director for Reimbursement/Coding to manage and oversee the revenue cycle operations. The role involves coordinating coding education, developing departmental goals, and ensuring compliance with federal and third-party billing guidelines. Candidates should possess a Bachelor's degree and certification in coding, along with extensive experience in reimbursement processes. This full-time position is critical for maximizing revenue opportunities across multiple clinic sites.

Qualifications

• 10 years of prior experience in healthcare billing is required.
• Three to five years of professional reimbursement experience is essential.
• Experience with Medicare/Medicaid reimbursement is necessary.

Responsibilities

• Manage and oversee department activities and coding education.
• Analyze reimbursement trends and implement improvement methods.
• Develop and maintain coding training programs for employees.

Skills

Management of revenue cycle

Reimbursement trend analysis

Coding education

Compliance with billing guidelines

Leadership skills

Education

Bachelor’s degree or equivalent

Certification in coding

Job description

Director, Reimb/Coding/Charges - Corporate Reimbursement/Coding - Full Time

Position Summary

Responsible for management and oversight of the assigned revenue cycle responsibilities within Guthrie Medical Group. Works closely with administrative leaders, managers, providers, and clinic personnel to ensure effective and efficient reimbursement and coding procedures for all clinic sites. Assigned area consists of nearly 20 FTEs. Also responsible for managing and coordinating the Clinic's master fee schedule, coding education program, and development/training of reimbursement policy and procedures. Responsible for managing the activities of the Clinic’s Radiology Coders, Surgical Coders, Centralized Inpatient, and Central Charge and overseeing revenue cycle complexities clinic wide.

Education, Licenses & Certifications

• Bachelor’s degree (or equivalent education and 10 years prior experience in healthcare billing) required.
• Certification in coding required.

Experience

• Three to five years of professional reimbursement experience.
• Medicare/Medicaid reimbursement experience required.
• Extensive experience working with providers related to coding education.

Essential Functions

• Manages and collaborates with Reimbursement employees to oversee and coordinate daily department activities.
• Leads and coordinates all coding education and payment audit activities with leadership staff to maximize revenue cycle operations.
• Provides leadership skills, clear direction, and establishes priorities to achieve targeted results to maximize reimbursement opportunities.
• Analyzes reimbursement trends and implements methods to improve reimbursements.
• Establishes and maintains a formal coding training program for employees and physicians.
• Demonstrates skills and proficiency in analyzing and troubleshooting complex reimbursement problems.
• Analyzes and maintains Clinic fee schedule.
• Responsible for development and creation of policies and procedures.
• Maintains comprehensive knowledge and complies with billing guidelines for federal, state, and third‑party payer contracts.
• Establishes and updates reports, departmental goals, initiatives, and performance metrics to AVP, Corporate Revenue Cycle.
• Provides ongoing analysis, supervision, and research of reimbursement related issues. Formulates and effectively communicates recommendations to avoid recurrence of future claim rejections, denials, or errors.
• Monitors coding rejections through creation and generation of performance metrics and reports. Analyzes and resolves issues preventing desired outcomes.

Other Duties

• Identifies and implements best practice opportunities to improve quality and quantity of work processed.
• Develops employee skills and knowledge base.
• Responsible for Human Resource activities (recruiting, interviewing, hiring, performance appraisals, development plans, disciplinary actions).
• Develops and implements departmental goals and initiatives.
• Participates in development of the department annual budget and monitors performance monthly.
• In collaboration with Director, develops a yearly plan of personal growth and development.
• Responsible for development of departmental goals and monitoring key performance indicators.
• Responsible for performance and directs assigned departments including budget development and monthly variance reports.
• Responsible for compliant application of regulatory and third‑party billing requirements, maintaining knowledge of policy and regulator compliance.
• Attends administrative meetings and participates in committees as requested. Conducts special projects, studies, and analysis as directed.
• Participates in professional development activities and maintains professional affiliations.
• Maintains confidentiality regarding patient accounting.
• Performs other duties as assigned.

Seniority Level

Director

Employment Type

Full‑time

Job Function

Other

Industries

Hospitals and Health Care