Manager, Inpatient Coding (Remote Candidates Considered)

Cape Cod Healthcare Inc; Hyannis (MA); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading healthcare provider is searching for an Inpatient Coding Manager to oversee coding functions, manage staff, and enhance compliance initiatives. This role requires strong leadership, regulatory knowledge, and the ability to work collaboratively with healthcare professionals. Candidates should have a Bachelor's degree, substantial coding experience, and relevant certifications. Join us to improve patient documentation quality and coding standards.

Qualifications

• Bachelor's degree or equivalent experience required, Master's preferred.
• Five years in acute care hospital coding required.
• Certification in CCS, RHIT, or RHIA required.

Responsibilities

• Manage inpatient coding staff and vendors.
• Ensure compliance with coding regulations.
• Develop and report performance measures to medical staff.

Skills

Regulatory Compliance

Communication

Leadership

Data Analysis

Education

Bachelor's degree

Master’s degree

Tools

Epic EMR

Job description

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Cape Cod Healthcare has been made aware of an instance in which a potential scammer has attempted to impersonate CCHC leadership and request chat interviews. Please note this is not our process and we will never direct you to interview solely through web-based chat. For any questions about available job opportunities or to learn more about our interview process please visit our careers page: https://www.capecodhealth.org/careers/

Job Description

Purpose of Position: Manages inpatient coding function and corresponding staff. Manages auditing and quality control and improvement initiatives, ensures compliance with internal policies and procedures and governing agencies, and works with HIM/Coding Director to assist with departmental needs and planning.

Description

• Ensure compliant quality coding and abstraction of clinical data.
• Manage CCHC staff and vendors performing inpatient coding and facilitate problem resolution of coding issues.
• Confirm supervisory staff are consistently performing performance-monitoring processes.
• Define, implement, and monitor strategies for improving documentation.
• Develop physician education strategies in conjunction with Clinical Documentation Improvement to promote complete and accurate clinical documentation.
• Develop and report performance measures to the medical staff and other departments of physician-specific information regarding documentation compliance.
• Collaborate extensively with physicians, nursing staff, and other patient caregivers to improve quality and completeness of documentation of care provided and coded.
• Manage concurrent modifications to clinical documentation to ensure proper reimbursement of clinical severity and services rendered to patients.
• Work with the business office to facilitate resolution of coding/billing issues.
• Develop and administer Quality Improvement (QI) and compliance initiatives.
• Monitor discharged not final billed daily accounts receivable and accounts (“DNFB”) and other metrics/benchmarks.
• Coordinate external audits and third-party reviews. Conduct exit interviews and implement appeal processes as required.
• Ensure staff address failed claim errors to billing edits, clinical trial codes, and other coding-related errors.
• Audit coding and medical record documentation systematically in accordance with NCCI and departmental policies, and create policies to enhance compliance.
• Maintain knowledge of regulatory and compliance changes impacting coding and ensure staff are educated and processes are updated.
• Manage to applicable coding KPIs. Define and implement action plans when performance is below expectations.
• Assess direct reports’ performance regularly and provide feedback to reward effective performance and facilitate improvement.
• Ensure inpatient coding employees and vendor staff perform coding functions in compliance with policies, processes, and quality assurance programs.
• Support IT in testing modifications and troubleshooting issues for the 3M Encoder and Epic EMR.

Consistently provide service excellence to all patients, family members, visitors, volunteers, and co-workers in a manner that reflects Cape Cod Hospital’s commitment to CARES: compassion, accountability, respect, excellence, and service.

Qualifications

• Bachelor's degree required or equivalent experience. Master’s degree preferred.
• Minimum five years’ experience in acute care hospital coding and validation.
• One of the following certifications required: CCS, RHIT, or RHIA.
• Strong knowledge of regulations for coding and hospital reimbursement.
• Experience in inpatient coding and DRG management, including supervisory experience and deficiency management.
• Thorough knowledge of medical terminology, anatomy, physiology, ICD-10, DRG grouping, and data analysis.
• Ability to influence within complex corporate relationships.
• Excellent communication, leadership, delegation, and interpersonal skills.
• 3-5 years of experience with health information systems and software, including Epic EMR or similar.
• Ability to evaluate performance, work under pressure, manage multiple initiatives, and meet deadlines.

Organization

Primary Location

Massachusetts-Hyannis

Department: HCI-HB Health Info Mgmt

Cape Cod Healthcare has been made aware of an instance in which a potential scammer has attempted to impersonate CCHC leadership and request chat interviews. Please note this is not our process and we will never direct you to interview solely through web-based chat. For any questions about available job opportunities or to learn more about our interview process please visit our careers page: https://www.capecodhealth.org/careers/