Senior Director Coding

Good Samaritan Society; Fargo (ND); On-site; USD 92,000 - 152,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Life insurance

401(k) retirement plan

Work/life balance benefits

Generous time off

Job summary

Sanford Health is seeking a senior leader in coding and revenue cycle to oversee hospital and professional coding, inpatient and outpatient facilities, and related denial/audit activities. You will guide strategy, budgeting, and IT-driven improvements across the system.

The role requires deep CPT knowledge, seven years in coding and seven years of management within a large health system, with certification in RHIT/RHIA/CPC/COC/CCS preferred. Strong regulatory and Medicare experience is essential.

Qualifications

• Bachelor’s degree required.
• Seven years of related work experience with CPT coding.
• Seven years of management experience in a large health care system.
• Knowledge of state and federal laws, rules and regulations.
• Experience with Medicare auditing and third-party reimbursement.
• Familiarity with computerized reporting systems.

Responsibilities

• Design, implement and optimize hospital and professional coding.
• Provide leadership for denial management and audit activity.
• Lead coding staff and drive performance in revenue cycle.
• Collaborate with Sanford Health leaders to ensure data integrity and compliant processes.
• Develop budget and strategic initiatives for coding services.

Skills

CPT coding knowledge

Denials/audits leadership

Leadership

Regulatory compliance

Education

Bachelor's degree

RHIT/RHIA/CPC/COC/CCS certifications

Tools

Computerized reporting systems

Job description

Careers With Purpose

Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America’s heartland.

Facility: Amber Valley
Location: Fargo, ND
Address: 4840 23rd Ave S #201, Fargo, ND 58104, USA
Shift: 8 Hours - Day Shifts
Job Schedule: Full time
Weekly Hours: 40.00
Salary Range: $67.00 - $110.50

Job Summary

Responsible for overall design, implementation and optimization of hospital and professional coding for Sanford Health. Provides leadership in the areas of clinic and hospital professional coding, hospital inpatient and outpatient facility coding, and hospital and professional denials/audits. Provides strategic planning and technical leadership and input on information systems. Directs and provides leadership to hospital and professional coding staff. Directs the processes and resolution of clinic and hospital professional coding and hospital facility related denials.

Provides direction and leadership for denial management and audit activity to include integrity of appeal process and policy. Demonstrates ability to develop, evaluate, monitor, educate, and analyze health system coding processes on a daily basis to increase productivity, ensure compliance is met utilizing all recognized coding guidelines and all payor policies and guidelines and the goals of Sanford Health are met.

Responsible for operational budget and strategic initiatives and formulation of Sanford Health's coding operating model and enhancement of coding related services throughout the system in order to drive and meet the goals of revenue services. Organize and streamline operations to achieve financial and service objectives. Develop and manage a multi-million dollar annual budget. Work extensively with IT. Develops reporting tools for Sanford leadership to help in fiscal budget planning and decision making, as well as education to reduce denial/RAC activity for the system.

Collaborates and coordinates with various Sanford Health leaders to ensure coding integrity and accurate data collection is achieved to support a seamless continuum of care, supporting provider compensation models, compliant processes, optimal reimbursement and efficient revenue cycle functions. Strengthens relationships by communicating department activity and outcome with other managers and service areas.

Participate in revenue cycle strategies and initiatives. Demonstrate vision and leadership in strategic planning and manage multiple competing priorities and diverse viewpoints. Lead by example, with initiative, self- discipline, confidence and professionalism to encourage and enable a management team and staff.

Sets vision and direction for developing and maintaining relationships between the Sanford provider community and coding. Supports Sanford's efforts to influence public policy at the state and federal levels.

Must demonstrate a broad-based knowledge of coding and billing practices.

Qualifications

Bachelor’s degree required.

Minimum seven years of directly related work experience and extensive knowledge of basic and underlying Current Procedural Terminology (CPT) coding practices required.

Minimum seven years of management experience in a large health care system with responsibility for coding practices.

Additionally, possess extensive knowledge of state and federal laws, rules and regulations and must be able to accurately interpret and apply these laws, rules and regulations. Experience in health care finance, rate setting procedures, and intermediary auditing related to Medicare. Experience analyzing and maximizing third party reimbursement, and experience with computerized reporting systems.

Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Outpatient Coder (COC) or Certified Coding Specialist (CCS) certification required.

Benefits

Sanford offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit https://sanfordcareers.com/benefits .

Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to [e-mail] .

Sanford has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.

Req Number: R-0274353
Job Function: Revenue Cycle
Featured: No