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HIM Manager of Coding HIM Full Time

2 months ago

Grand Rapids MI United States Pine Rest Christian Mental Health Svc Full time
Cost Center

Health Information Management

Scheduled Weekly Hours

40

Work Shift

Shift & Status

Who Are We?

We at Pine Rest believe in the power of healing and that everyone in our community has the right to expert care for mental health and substance use disorders. We are much more than just the third largest non-profit behavioral health system in the country, our 220-acre main campus, and our network of clinical sites across Michigan. We are a tight-knit community of healers who witness the impact of our life-changing work each day.

Each day, we are closing the gaps in access to care. We are innovating through leading-edge research, testing, programs, and treatment modalities that others replicate across the country. Our services include a state-of-the-art psychiatric urgent care center and a soon-to-be-built pediatric behavioral health center, outpatient, inpatient, partial hospitalization (day programs), assessment and testing, residential, addiction treatment and specialty services such as crisis response, employee assistance programs, forensic psychiatry and psychology, and neuromodulation. On-the-job educational programs for nurses, psychologists, advanced practice providers, psychiatrists, and chaplains are equipping the next generation of care providers.

We are passionate about serving and are honored to be a part of this incredible work.

Position Summary:

The HIM Coding Manager is responsible for overseeing the coding and clinical documentation improvement operations within the organization. This role involves managing a team of coders and coding auditor, ensuring compliance with coding guidelines and regulations, maintaining accuracy in coding for reimbursement and enhancing the efficiency of the coding process. The position manages and oversees daily coding operations, including but not limited to overseeing the department and staff, data collection, analysis, and reporting to meet department and organization wide goals. Requires excellent critical thinking skills and knowledge of MS-DRGs, APCs, Official Coding Guidelines, DSM-5, and a broad-based and thorough understanding of ICD-10 CM/PCS coding and CPT/HCPCS systems. Ability to adapt to changes in the workload and work functions, to work independently and to effectively prioritize work assignments. Must have in-depth knowledge of facility and professional behavioral health coding process, workflow management and electronic health records. The position requires a high degree of collaboration with clinicians, health care providers, and Revenue Cycle across HRS and ORS The HIM Coding Manager is responsible for planning, implementing, and educating coding staff, physicians, nurses, and other departments to ensure clinical documentation quality, coding quality and timely reimbursement.

Principal Duties and Responsibilities:

Manages, supervises, and monitors daily work activities, work queues, evaluates, trains, and motivates the performance of staff.
Manages staffing plans and work assignments to achieve and maintain established productivity thresholds.
Monitors productivity standards to achieve maximum efficiency levels.
Provides direction and manages the day-to-day function within the coding department.
Establishes and monitors the quality of the departments aligned with coding to support accurate patient information, compliant coding aligned with billing regulations and minimized corrections and re-work.
Promotes recruitment and retention of certified coding staff in coding positions.
Educate and train coding staff, acts as a professional subject matter expert and mentor to the staff.
Enforces coding policies and procedures, conducts trend analysis to identify pattern and variations in coding department.
Works closely with other departments involved with revenue cycle to resolve issues and improve processes.
Accomplishes developmental goals, objectives and training as determined by the previous year's evaluation.
Eliminates unnecessary operations and is innovative with cost containment and reduction.
Enforces established Human Resources and Hospital policies and procedures.
Utilizes the performance appraisal process as an effective management tool of evaluation.
When necessary, acts to discipline employees and recognize employee achievements.
Monitors coding work queues, unbilled accounts, aging of accounts to ensure timely filing of claims, and monitors coding workflows.
Ensures coders meet 95% facility coding accuracy on quarterly coding audits.
Ensures coders meet 90% professional coding accuracy on quarterly coding audits.
Keeps abreast of new technology in coding and coding guidelines, stays informed about future issues impacting the coding functions, and acts as a liaison for other departments regarding coding questions.
Manage, train and educate staff as it pertains to denials in coding; reviewing, coordinating, and monitoring the denial management and appeals process in a collaborative environment with area management and partners within HRS and ORS.
Manage the Coding team including but not limited to: hiring, training, managing & evaluating team performance and conducting professional development plans.
Ensure that the productivity and actions of the Coding team meet and support the overall operational goals of the department and institution.
Works with HIM-Operations manager for development and management of annual budget and identifies opportunities to decrease cost and improve services.
Design, develop and execute standard policies and procedures, standardized queries, and strategies targeted to improve the quality of documentation and overall quality and financial performance of Pine Rest Christian Mental Health Services
Maintains the knowledge base to assist with the coding functions for facility and professional, as needed.
Develop and execute Coding process improvement projects (department and organization wide)
As needed, ensure all appeals are completed timely and that sound clinical evidence and coding clinic information is submitted.
Collaborate extensively with members across organization to provide data and solution development processes.
Inform and educate coding staff or other departments of regulatory (CMS/TJC) and 3rd party payor regulatory updates and implements policy/guidelines to ensure compliance with changes.
Counsel Coding team on actions required to meet minimum performance requirements.
Maintains a professional relationship with management, employees, patients, and providers always.
Complies in all material respects with the Corporate Integrity Policy, all federal, State, and local laws and regulations applicable to position.
Notifies supervisor or Corporate Integrity committee if any violations are suspected.
Responsible to role model the mission and values of the organization, presenting a professional image that is projected in appearance, attitudes and behaviors, time management and communication skills.
Seeks and maintains membership in professional organizations to expand personal knowledge base and develop professional contacts.
Delegates responsibilities within the scope of personnel abilities.
Demonstrates ability for professional growth by attending continuing education and in-service programs.
Demonstrates a thorough knowledge and understanding of revenue cycle policies and procedures in performing job duties
Maintains current knowledge of coding/billing requirements for both professional and facility coding for all payers.
Able to identify and evaluate personal strengths and weaknesses and provide a plan for the improvement of weak areas.
Responsible for developing proper attitudes toward health and safety for the department and organization, and for ensuring that all operations are performed with the utmost regard for the safety and health of all personnel involved.
Continuously review and evaluate safety practices and will take appropriate action as needed.
Participates in HRS, Professional, and Community Organizations/Committees.
Commitment to demonstrating the Hospital and Residential Services Model of Care.
Responsible to uphold the healing ministry of Christ through relationships that honor integrity, stewardship, empowerment, the promotion of diversity and professional excellence.
Must maintain annual training and demonstrate competency in the required programmatic training.
Performs other duties or functions as assigned.

Supervisory Responsibilities:

Direct supervision of all Coders and Coding Auditor.

Required/Desired Qualifications:

Education, Training, and Experience:

Bachelor's degree in health information management or related field.
RHIA or RHIT with CCS required or certification within first 6 months of hire.
Minimum of five (5) years of coding in physician and or academic healthcare organization and to include three (3) years supervisory/management progressive leadership experience.
Effective oral and written communication skills.
Proficient knowledge of Official Coding and Clinical Documentation Guidelines
Familiarity of automated/computerized encoders, groupers, abstracting, and Epic EHR
Previous experience in behavioral health coding
Previous work in mental and behavior health

Specific skills, knowledge, and abilities:

Ability to provide care/service within the scope of: Holding a conviction to express Christ's love and compassion to recipients of services, coworkers, and surrounding communities through integrity, stewardship, empowerment, the promotion of diversity, equity, inclusion, and professional excellence click apply for full job details