Job type: Direct Hire
Required Certification: CCS
Preferred: RHIA or RHIT
Location: Boston, MA
The Corporate Inpatient Coding Manager shall be responsible for Inpatient coding functions within the Division. The Inpatient Coding Manager shall ensure a 96% or better DRG/APR-DRG accuracy and that all patient type productivity standards are met consistently.
- Direct management responsibility over all division inpatient coding.
- Oversight over all hospital based concurrent coders.
- Extensive knowledge of DRG and APR-DRG classification and reimbursement structures. Including IPF-PPS (Inpatient Psychiatric Facility Prospective Payment System) and IRF PPS (Inpatient Rehabilitation Facility Prospective Payment System).
- Responsible for 96% or better DRG/APR-DRG accuracy rate.
- Responsible for 93% or better moderate coding accuracy rate (C1).
- Responsible for scheduling coder work shifts and approving time off.
- Ensure that a provisional DRG is assigned within 24 hours of admission for all Inpatient accounts excluding Normal Newborn and Obstetrical Moms.
- Responsible to ensure coders are meeting productivity standards. Includes presenting a monthly report to the Executive Director, Health Information Management.
- Ensure that claim hold reason is assigned before account hits DNFB report.
- Ensure that second level review is completed on all PSI and Never Event cases.
- Maintain open communication with hospital leadership team including daily escalation of missing reports from providers.
- Trend and track coding queries issued by discharged coders.
- Ensure coding staff holds accounts until all medical content is collected before final billing.
- Promote a culture of collaboration between hospital leadership and shared service professionals.
- Coordinate workflow improvements with HIM Operations Management.
- Ability to develop, adhere to, and monitor policies and procedures for optimal revenue through coding that comply to all regulatory and compliance standards.
- Supports collaboration between remote Inpatient Coders, hospital based Concurrent Coders, and CDI.
- Abides by the Standards of Ethical coding set forth by AHIMA and monitors coding team.
- Present monthly status and goal report to Executive Director, Health Information Management.
- Maintain Discharged, but Not Final Billed goals set by Executive Director, Health Information Management.
- Ensure policies related to HIM, Revenue Cycle, and Compliance are implemented and monitored.
- Implement HIM related projects at the direction of the Executive Director, Health Information Management.
- Support hospital based departments such as Quality, Risk Management, and Case Management with respect to HIM coding.
- Assists HIM Leadership team with development and implementation of health information management coding/CDI policies.
- Monitors changes in legislation and accreditation standards that affect health information management.
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