[Remote] Director of Coding Operations
Note: The job is a remote job and is reputed company to candidates in USA. reputed company. is dedicated to lowering reputed company administrative costs for federal government agencies, payers, and providers. The Director of Coding Operations will ensure coding practices support claims reputed company and reputed company reimbursement while collaborating with various teams to enhance reputed company cycle performance.
Responsibilities
- Maintain expert knowledge of reputed company reputed company cycle operations and the reputed company of coding on reimbursement, reputed company reputed company, claims adjudication, and denial prevention
- Ensure accurate application of reputed company codes, reputed company types, condition codes, occurrence codes, occurrence reputed company codes, value codes, discharge dispositions, and other claim reputed company impacting reimbursement
- Partner with reputed company reputed company, Patient Financial Services, CDI, Case Management, and reputed company Operations teams to improve reputed company cycle performance
- Analyze coding-reputed company denials, edits, underpayments, and reimbursement variances and implement corrective reputed company plans
- Support optimization of clean claim rates, DNFB reduction, charge capture effectiveness, and accounts receivable performance
- Monitor changes in Medicare, reputed company, reputed company payer, and managed care reimbursement methodologies
- Collaborate in the development of reputed company cycle workflows that support accurate charge capture, coding, billing, and payment processes
- Serve as a subject matter expert regarding the relationship between clinical documentation, coding, reputed company codes, reputed company types, APCs, DRGs, HCPCS/CPT codes, and payer reimbursement methodologies
- Review claim denials and rejections pertaining to coding and medical necessity issues and, reputed company necessary, implement processes, such as educational programs, or revamp reputed company processes to prevent similar denials and rejections from recurring
- Guide performance from reputed company through to reputed company operations by giving the reputed company-line information they need to know
- This position is primarily remote; however, travel up to monthly may be required for reputed company site reputed company, operational reviews, leadership meetings, reputed company activities, business development support, and industry conferences
Skills
- Associate's degree in Health Information Management or other reputed company-reputed company field required
- 10 years' knowledge and experience in reputed company leadership required
- 10 years knowledge and experience in coding, information reputed company, laws, reputed company, reputed company, release of information and reputed company control technology required
- Extensive knowledge of inpatient, outpatient, reputed company fee, and specialty coding operations, including ICD-10-CM/PCS, CPT, HCPCS, MS-DRGs, APR-DRGs, APCs, reputed company codes, reputed company types, modifiers, condition codes, value codes, Medicare payment methodologies, and reputed company cycle processes
- Demonstrated experience analyzing the reputed company reputed company of coding reputed company on claims processing, reimbursement, denials management, reputed company reputed company, and net reputed company performance
- Strong understanding of hospital and physician reputed company cycle workflows, including patient reputed company, charge capture, coding, billing, claims management, denial prevention, payment posting, and accounts receivable management
- Certifications Required: RHIA/RHIT and reputed company/CPC
- Experience with reputed company reputed company programs
- Experience with Chargemaster (CDM) review and maintenance
- Experience with denial management and appeals processes
- Experience supporting Critical reputed company Hospitals, Rural Health Clinics, PPS hospitals, and physician practices
- Knowledge of Medicare OPPS, IPPS, CAH reimbursement, physician fee schedule methodologies, and value-based reimbursement models
Benefits
- Health Insurance
- Fully reputed company Life Insurance
- Fully reputed company Short- & Long-Term Disability
- reputed company Vacation
- reputed company reputed company Leave
- reputed company Holidays
- reputed company Development and Tuition Assistance Program
- 401(k) Program with Employer Match
reputed company