PRN Clinical Coding Reimbursement Compliance Manager

Harris Health; Houston (TX); Hybrid; USD 75,000 - 95,000; Full time

Benefits offered by this job

Telecommuting eligibility

Job summary

Harris Health in Houston, Texas is looking for a Compliance Officer to develop and maintain a data quality compliance plan for hospital coding and reimbursement. This role requires strong experience in coding management and the ability to communicate effectively with various stakeholders.

The ideal candidate will possess extensive knowledge of ICD-10-CM and demonstrate exceptional coding skills, along with proficiency in MS Office. This position is eligible for telecommuting and reports to the VP of Compliance.

Qualifications

• 5+ years of experience in coding management in a large acute care hospital.
• Strong background in ICD-10-CM and knowledge of medical terminology.
• Management experience required.

Responsibilities

• Develop and maintain a data quality compliance plan for coding.
• Create standards, policies, and procedures related to HIM coding compliance.
• Conduct audits to validate DRG, APC, and coding accuracy.

Skills

ICD-10-CM classification systems

Communication Skills

Public Speaking

MS Access

MS Excel

MS Word

Education

Bachelor's Degree and 5 years of coding management

High School Diploma or GED and 9 years of coding management

Tools

PC

Job description

Overview

Harris Health System 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, and holds additional designations and partnerships with leading medical institutions.

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 ensure a 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.

Responsibilities

The role involves developing and maintaining the data quality compliance plan for coding and reimbursement, creating standards, policies and procedures, and delivering education and training related to HIM coding compliance. It includes communicating documentation and accurate coding to HIM staff, physicians, billing personnel, and ancillary departments, coordinating reviews of targeted areas to support timely billing, and performing random audits to validate DRG, APC and other coding accuracy to ensure compliance.

Minimum Qualifications

• Bachelor's Degree (and) Five (5) years of work experience coding management in a large acute care hospital setting.
• (Or) High School Diploma or GED (and) Nine (9) years of work experience coding management 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, PC

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.