PRN Clinical Coding Reimbursement Compliance Manager

Harris Health; Houston (TX); Remote; USD 90,000 - 120,000; Full time

Benefits offered by this job

Telecommute eligible

Job summary

Harris Health is seeking a Compliance Data Specialist to work with senior leaders on developing and maintaining a data quality compliance plan for hospital coding and reimbursement across inpatient and outpatient settings.

Reporting to the VP/Deputy Compliance Officer, you will establish standards and training programs, ensure accurate DRG and APC coding, and coordinate targeted reviews to support timely, compliant billing across Harris County facilities.

Qualifications

• Bachelor's degree with 5+ years coding management experience in a large acute care hospital.
• Or high school with 9+ years coding management experience in a large acute care hospital setting.

Responsibilities

• Develop, implement and maintain a data quality compliance plan for coding and reimbursement.
• Educate and train staff on HIM coding compliance elements.
• Coordinate audits to validate DRG, APC coding accuracy and timely billing.

Skills

Data quality

Compliance

Communication

Training

Education

Bachelor's Degree in related field

High School Diploma or GED

Tools

MS Access

MS Excel

MS Word

Job description

About Us

Harris Health is the public healthcare safety-net provider established in 1966 to serve the residents of Harris County, Texas. As an essential healthcare system, Harris Health champions better health for the entire community, with a focus on low-income uninsured and underinsured patients, through acute and primary care, wellness, disease management and population health services. Ben Taub Hospital (Level 1 Trauma Center) and Lyndon B. Johnson Hospital (Level 3 Trauma Center) anchor Harris Health's robust network of 39 clinics, health centers, specialty locations and virtual (telemedicine) technology. Harris Health is among an elite list of health systems in the U.S. achieving Magnet® nursing excellence designation for its hospitals, the prestigious National Committee for Quality Assurance designation for its patient-centered clinics and health centers and its strong partnership with nationally recognized physician faculty, residents and researchers from Baylor College of Medicine; McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth); and The University of Texas MD Anderson Cancer Center.

At Harris Health, we prioritize the well-being of our most valuable asset--our people--ensuring a culture of compassion, collaboration and excellence in serving Harris County's most in need. With integrity and accountability at our core, we commit to 'leading with love', embodying our dedication to quality care, education, and a steadfast respect for every individual's contribution to our mission.

Job Summary

Working with the Vice President/Deputy Compliance Officer and Director Compliance and Audit for Corporate Compliance, this position is responsible for developing, implementing and maintaining a data quality compliance plan for hospital inpatient/outpatient coding and reimbursement. The person in this position is responsible for development of standards, policies, and procedures as well as education and training programs regarding elements of the HIM coding compliance. This includes documentation and accurate coding to all appropriate personnel, including HIM coding staff, physicians, billing personnel and ancillary departments. This person will also coordinate and conduct review of targeted areas to assume timely billing process, correct hospital reimbursements and perform random audits to validate accuracy of DRG, APC, and other coding to ensure compliance with coding and billing requirements.

Minimum Qualifications

• Bachelor's Degree (And) Five (5) Years Work Experience coding management experience in a large acute care hospital setting.
• (Or)
• High School Diploma or GED (And) Nine (9) years work experience coding management experience in a large acute care hospital setting.

Licenses & Certifications

• Certified Coding Specialist (or) CCS-P from AHIMA
• Certified Inpatient Coder (CIC)
• Management Experience: Five (5) years management experience
• Communication Skills: Exceptional Verbal (e.g., Public Speaking)
• Proficiencies: MS Access, MS Excel, MS Word, P.C.
• Job Attributes
  Work Schedule: Eligible for Telecommute

Other Requirements

Must have a strong background in ICD-10-CM Classification systems, knowledge of anatomy and physiology, clinical medical and medical terminology, along with excellent working and current knowledge of federal and the All-Payer DRG reimbursement methodology for hospital (facility) billing.