Director, Inpatient Coding and Compliance

Accountabilities • Provide administrative leadership for coding services, clinical documentation enhancement, data quality management, and Medical Information Management compliance programs.

• Oversee accurate, timely, and complete coding of inpatient and outpatient accounts using applicable ICD-10-CM/PCS and CPT-4 classification systems and related billing requirements.

• Lead the review and monitoring of coding accuracy, documentation quality, data integrity, billing accuracy, and program timeliness.

• Manage the abstraction of critical data elements required for billing and reporting, including admission type and source, discharge disposition, and attending physician information.

• Develop, maintain, and monitor the department’s compliance plan, including compliance assessments, education, policies and procedures, monitoring activities, and corrective action.

• Ensure coding and data abstraction practices align with applicable CMS regulations and organizational compliance requirements.

• Analyze coding performance and medical record documentation to identify trends, risks, inconsistencies, and opportunities for improvement.

• Partner with data analysts and documentation leadership to monitor Case Mix Index and identify opportunities to improve coding accuracy and documentation quality.

• Respond to identified coding errors and inconsistencies and coordinate appropriate corrective or educational actions.

• Direct continuing education initiatives for coding, documentation enhancement, and data quality management staff.

• Benchmark coding, compliance, quality, and timeliness results against relevant peer organizations and use findings to support continuous improvement.

• Advise administrative, medical, and managerial stakeholders on coding, documentation, compliance, utilization management, financial performance, strategic planning, and information needs.

• Maintain strong working relationships with Case Management, Access and Revenue Management, Business Planning, Information Warehouse, and other organizational partners.

• Provide authorized patient- and physician-specific information from applicable data systems, data marts, and information warehouses for administrative and research purposes.

• Provide departmental leadership, direction, supervision, and support when the Administrative Director is unavailable.

• Resolve intra-departmental and cross-functional issues related to coding, documentation, data quality, and compliance.

Requirements

• Bachelor’s degree in Health Information Administration or an equivalent field.

• Active Registered Health Information Administrator (RHIA) credential through the American Health Information Management Association (AHIMA).

• At least 10 years of relevant professional experience; 15 or more years is preferred.

• Extensive knowledge of healthcare coding, medical information management, clinical documentation enhancement, data quality, and compliance practices.

• Strong understanding of inpatient and outpatient coding processes, including ICD-10-CM/PCS and CPT-4 classification systems.

• Knowledge of CMS coding, billing, data abstraction, and compliance requirements.

• Demonstrated experience leading teams, programs, policies, and operational initiatives within a complex healthcare environment.

• Strong analytical skills, with the ability to interpret coding, documentation, quality, reimbursement, and performance data and translate findings into actionable recommendations.

• Excellent organizational and problem-solving abilities, with the capacity to manage competing priorities and complex operational issues.

• Strong written and verbal communication skills, including the ability to advise clinical, administrative, financial, and managerial stakeholders.

• Ability to develop and deliver education and continuing professional development programs.

• Strong collaboration skills and the ability to build effective relationships across multidisciplinary departments.

• High level of attention to accuracy, confidentiality, compliance, and data integrity.

• Ability to work independently and provide effective leadership in a fully remote environment.

• Successful completion of a background check is required for final candidates; a drug screen or physical may also be required as part of the post-offer process.

Benefits

• Fully remote position within the United States.

• Full-time, regular position with a 40-hour workweek and first-shift schedule.

• Medical, dental, and vision coverage, with a significant portion of premiums covered by the employer.

• Paid time off, including vacation and sick leave.

• 11 paid holidays.

• State retirement plan or an alternative retirement plan, with generous employer contributions.

• Opportunity to lead high-impact coding, documentation, data quality, and compliance programs within a large and complex academic healthcare environment.

• Access to professional growth and development opportunities.

• Collaborative environment involving healthcare, administrative, financial, clinical, research, and data-focused teams.

How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best! Why Apply Through Jobgether?

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