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The Director, Coding oversees, directs and provides strategic leadership of the coding function within the Revenue Integrity Department, Revenue Cycle Division. Responsible for the management of hospital and outpatient coding operations including ICD and CPT code assignment, case abstracting, select case charge capture, pre-bill quality reviews and other billing edit work queues.
The essential functions listed are typical examples of work performed by positions in this job classification, and are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Specific duties and responsibilities may vary depending on department or program needs without changing the general nature and scope of the job or level of... responsibility. Employees may also perform other duties as assigned.
Employees must perform all duties and responsibilities in accordance with the C-I-CARE Standards of the Hospital. C-I-CARE is the foundation of Stanford's patient-experience and represents a framework for patient-centered interactions.
Partners with CDI, Quality Reporting, PFS, Professional Coding, Compliance, Medical Staff leadership and other departments to assure common goals are met.
Serves as the primary coding subject matter expert for the enterprise, serving on an array of business operations and clinical committees.
Accountable for active daily management of Discharged Not Billed (DNB) work queues to assure targets are consistently met.
Assures appropriate staffing levels and adherence to fiscal targets.
Participates in the formulation of objectives and strategies for integrating coded clinical information to support goals for patient care, teaching, research, and optimizing management of resources.
Develops and manages key coding performance indicators and metrics.
Develops and oversees a comprehensive quality assurance and productivity program for coding staff.
Assures coding staff is provided with the technology and education to support optimal performance.
Collaborates with leadership to optimize workflows and EHR technology.
Manages on-site coding managers, coding quality specialists, coding education coordinator, coders as well as remote coding staff.
Directs the preparation of routine and custom reports to management and clinical leadership.
Demonstrates in-depth working knowledge of ICD, CPT, MS-DRGs and APR-DRGs code classifications/groupers with ability to analyze and trend key metrics including CMI.
Directs and oversees the coding/abstracting activities in accordance with SHC policies and procedures, external agency requirements, AHA's Coding Clinic and other relevant industry standard guidelines.
Assures the accurate and timely completion of all coding related activities.
Provides consultation across the enterprise regarding coding and medical record documentation guidelines to assure compatibility and compliance with all regulatory, third party and SHC policies.
Provides leadership and direction for the establishment and maintenance of documentation standards and policies and procedures related to coding activities.
Collaborates with other key stakeholders in the creation of effective programs and initiatives as related to physician quality profiles and financial performance.
Communicates clearly, proactively and concisely with all key stakeholders.
Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.
Education: Bachelor's degree in a work-related discipline/field from an accredited college or university
Experience: Seven (7) years progressively responsible and directly related work experience.
License/Certifications: Certified Coding Specialist (CCS) or Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) from the American Health Information Management Association (AHIMA)
Knowledge, Skills And Abilities
These are the observable and measurable attributes and skills required to perform successfully the essential functions of the job and are generally demonstrated through qualifying experience, education, or licensure/certification.
Ability to conduct analyses and formulate conclusions based on them.
Ability to develop long-range business plans and strategies.
Ability to foster effective working relationships and build consensus.
Ability to mediate and resolve complex problems and issues.
Ability to plan, organize, develop tactical plans and set priorities.
Ability to provide leadership and influence others.
Ability to facilitate small to large groups of people at various organizational levels for purposes of planning, problem solving, or strategy development.
Possesses excellent interpersonal skills in building, negotiating and maintaining crucial relationships.
Knowledge of electronic Health Information Management trends, operations, and best practices.
Knowledge of federal and state laws, regulations and regulatory practices affecting the medical and business practices of healthcare providers.
Knowledge of local, state and federal regulatory requirements related to areas of functional responsibility.
Knowledge of principles and practices of organization, administration, fiscal and personnel management.
Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements