Director, Reimb/Coding/Charges - Corporate Reimbursement/Coding - Full Time

Position Summary:

Responsible for management and oversight of the assigned revenue cycle responsibilities within Guthrie Medical Group. Works closely with administrative leaders, managers, providers, and clinic personnel to ensure effective and efficient reimbursement and coding procedures for all clinic sites.

Assigned area consists of nearly 20 FTE's. In addition, responsible for managing and coordination of the Clinic's master fee schedule, coding education program, and the development and training of reimbursement policy and procedures. Responsible for managing the activities of the Clinic's Radiology Coders, Surgical Coders, Centralized Inpatient, and Central Charge as well as oversight and coordination of revenue cycle complexities clinic wide.

Education, License & Cert:

Bachelor's degree is required. This requirement may be satisfied through an equivalent combination of education and 10 years prior experience in healthcare billing. Certification in coding required.

Experience:

Three to five years of professional reimbursement experience. Medicare/Medicaid reimbursement experience required. Extensive experience working with providers related to coding education

Essential Functions:

1.Manages and collaborates with Reimbursement employees to oversee and coordinate daily department activities.

2.Leads and coordinates all coding education and payment audit activities with leadership staff to maximize revenue cycle operations.

3.Provides leadership skills, clear direction, and establishes priorities to achieve targeted results to maximize reimbursement opportunities.

4.Analyzes reimbursement trends and implements methods to improve reimbursements.

5.Establishes and maintains a formal coding training program for employees and physicians.

6.Demonstrates skills and proficiency in analyzing and troubleshooting complex reimbursement problems.

7.Analyzes and maintains Clinic fee schedule.

8.Responsible for development and creation of policies and procedures.

9.Maintains comprehensive knowledge and complies with billing guidelines for federal, state, and third‐party payer contracts.

10. Establishes and updates reports, departmental goals, initiatives, and performance metrics to AVP, Corporate Revenue Cycle.

11. Provide ongoing analysis, supervision, and research of reimbursement related issues. Formulates and effectively communicates recommendations to avoid recurrence of future claim rejections, denials, or errors.

12. Monitors coding rejections through creation and generation of performance metrics and reports. Analyzes and resolves issues preventing desired outcomes.

Other Duties:

1.Identifies and implements best practice opportunities to improve the quality and quantity of work processed.

2.Develops employee skills and knowledge base to ensure daily departmental functions are performed.

3.Responsible for Human Resource activities, including recruiting, interviewing, hiring, performance appraisals, development plans and disciplinary actions. Provides ongoing performance feedback.

4.Develops and implements departmental goals and initiatives.

5.Participates in the development of the department annual budget and monitors performance monthly.

6.In collaboration with Director, develops a yearly plan of personal growth and development.

7.Responsible for development of departmental goals and monitoring key performance indicators.

8.Responsible for performance and directs assigned departments including budget development and monthly variance reports.

9.Responsible for the compliant application of regulatory and third‐party billing requirements. Maintains knowledge of and complies with established policies and procedures including government, insurance, and third‐party payer regulations.

10. Attends administrative meetings and participates in committees as requested. Conducts special projects, studies, and analysis as directed.

11. Participates in professional development activities and maintains professional affiliations.

12. Maintains confidentiality in regard to patient accounting. 13. Performs other duties as assigned.