Regional Director Coding
Apply NowCompany: McLaren Health Care
Location: Michigan Center, MI 49254
Description:
JOB SUMMARY
TheRegional Director of Coding is responsible leading Revenue Cycle Coding, Auditand an Account Resolution Departments. Functional assignments include managementof facility and professional coding services, managing internal and external auditing,customer service, and coding information system analysis and management. Develops and implements plans to ensure theachievement of established objectives. Represents Coding, Auditing, Accounts Resolution and Revenue Cycle inmeeting strategic objectives throughout the McLaren System. The Regional Director is expected to be acontributing member of the Revenue Cycle leadership team. Demonstrates the philosophy and core valuesof McLaren Health Care in the performance of duties.
ESSENTIAL FUNCTIONS& RESPONSIBILITIES
1. ManagesDischarge Not Final Billed (DNFB) and Discharge Not Final Coded (DFNC) for theMcLaren system.
2. Providesleadership throughout the system in regard to facility and professional Coding,managing internal and external auditing and account resolution inquiries.
3. Worksclosely with the central business office to improve processes impacting the DischargeNot Final Coded (DFNC) and Discharge Not Final Billed (DNFB).
4. Strongknowledge of healthcare facility and professional claims processing includingICD-10, CPT, HCPC, PCS, NDC codes and modifiers as well as thorough knowledgeof UB and 1500 claim edits.
5. Workingknowledge of Medicare, Medicaid, and Third Party reimbursement methodologies.
6. Readand interpret provider contracts to determine billing discrepancies.
7. Managesvendors coding and auditing contracts.
Required:
Preferred:
Equal Opportunity Employer of Minorities/Females/Disabled/Veterans
TheRegional Director of Coding is responsible leading Revenue Cycle Coding, Auditand an Account Resolution Departments. Functional assignments include managementof facility and professional coding services, managing internal and external auditing,customer service, and coding information system analysis and management. Develops and implements plans to ensure theachievement of established objectives. Represents Coding, Auditing, Accounts Resolution and Revenue Cycle inmeeting strategic objectives throughout the McLaren System. The Regional Director is expected to be acontributing member of the Revenue Cycle leadership team. Demonstrates the philosophy and core valuesof McLaren Health Care in the performance of duties.
ESSENTIAL FUNCTIONS& RESPONSIBILITIES
1. ManagesDischarge Not Final Billed (DNFB) and Discharge Not Final Coded (DFNC) for theMcLaren system.
2. Providesleadership throughout the system in regard to facility and professional Coding,managing internal and external auditing and account resolution inquiries.
3. Worksclosely with the central business office to improve processes impacting the DischargeNot Final Coded (DFNC) and Discharge Not Final Billed (DNFB).
4. Strongknowledge of healthcare facility and professional claims processing includingICD-10, CPT, HCPC, PCS, NDC codes and modifiers as well as thorough knowledgeof UB and 1500 claim edits.
5. Workingknowledge of Medicare, Medicaid, and Third Party reimbursement methodologies.
6. Readand interpret provider contracts to determine billing discrepancies.
7. Managesvendors coding and auditing contracts.
Required:
- Bachelor's Degree required in Accounting, Business Management or closely related field in order to understand the impact of the revenue cycle on the performance of the health system.
- Fifteen (15) years' experience in a progressively more responsible leadership role in Health Information Management/Coding and/or Revenue Cycle with demonstrated supervisory responsibility in health care.
- RHIT or RHIA
Preferred:
- MBA or MHA or MHIT
Equal Opportunity Employer of Minorities/Females/Disabled/Veterans