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Job SummaryResponsible for coding practices that assure accuracy, optimal reimbursement, adherence to coding guidelines and regulatory compliance in an integrated healthcare system. Responsible for hiring, training, monitoring, and on-going education of all Prisma Health Health Information Management coding team members. Collaborates with providers, other departments and leaders, serving as the coding expert and consultant. Provides feedback and focused educational programs on the results of auditing/monitoring activities. Serves in an advisory and educator capacity to the coding staff, medical staff, billing/reimbursement departments, and chargemaster coordinator as it relates to documentation, coding, and regulatory compliance. Works directly with Patient Financial Services to achieve revenue cycle goals.
- Directs the activities of all Prisma Health HIM coding/abstracting functions and personnel.
- Develops and implements policies and procedures to monitor quality of coding/abstracting and productivity for all HIM areas in accordance with the Prisma Health Quality Coding Assurance Program (Compliance Program).
- Assists the Director of HIM by recommending strategies to assure timely coding and abstracting of medical information. Collaborate with Director to develop FTE, Capital and Expense Budgets. Operates within the established budget. Identifies and implements opportunities for improved financial performance
- Serves as a coding advisor and system expert for coding guidelines and utilization of coded data for internal and external reporting
- Participates in coding audits and reviews payer denials as it pertains to coding and documentation, working collaboratively with the clinical documentation integrity team to assure the medical record documentation reflects the severity of illness and supports the coded claim. Responds to questions regarding assignment of codes/DRGs/APCs from insurance carriers, peer review organizations, physicians, and all other internal and external auditors.
- Maximizes the use of technology to support coding workflow, efficiency and productivity. Assures coding applications and systems have timely updates of ICD-10 and CPT codes when published.
- Maintains a current and comprehensive coding quality and compliance program to include audit plan, reporting, and education to support industry and CMS guidelines
Job has direct and/or indirect supervision of team members that may include final budget authority, hire/termination authority, performance appraisal responsibility and disciplinary authority. Job will be considered a member of management staff at Prisma Health Company or affiliate and will have direct reports.
- Bachelor's Degree in Health Information Management
- 5 years of Health Information Management Coding with at least 2 years in a management or leadership role.
- RHIT or RHIA credentialed by AHIMA (Lawson Code C012)
- CCS or CCS-P
In Lieu Of The Above Minimum Requirements
In lieu of the education and experience listed above, an Associate's degree in Health Information Management and 7 years experience managing a hospital HIM coding team.
Other Required Skills and Experience
- Previous experience as trainer/educator preferred
- Epic experience preferred
Work ShiftDay (United States of America)
Location5 Medical Park Rd Richland
Facility1500 Midlands Corporate
Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
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