Manager, Clinic & Outpatient Coding
Requisition #: 185002
Location: Johns Hopkins Hospital/Johns Hopkins Health System, Baltimore, MD 21201
Work Shift: Day Shift
Work Week: Full Time (40 hours)
Weekend Work Required: No
Date Posted: April 22, 2019
Johns Hopkins Health System employs more than 20,000 people annually. When joining the Johns Hopkins Health System, you became part of a diverse organization dedicated to its patients, their families, and the community we serve, as well as to our employees. Career opportunities are available in academic and community hospital settings, home care services, physician practices, international affiliate locations and in the health insurance industry. Great careers continually advance here.
The Manager of Clinic & Outpatient Coding, under the leadership of the Director of Outpatient Coding Operations, is responsible for providing daily operational leadership for the clinic and outpatient ancillary coding services for the Johns Hopkins Health System. This position requires knowledge and experience managing Outpatient Coding Operations in a complex, multi-facility, Academic and Community environment and will be responsible for the overall performance of Outpatient Coding, across multiple facilities, through a Shared Services Model. The Manager of Clinic & Outpatient Coding will demonstrate a high command of the Revenue Cycle, the cause and effect of department charges and documentation, claim edits and denials, coding modifiers, and the relationships of billing and coding edits. The Manager will demonstrate strong customer service and collaboration skills, the ability to develop the leadership needed to manage performance expectations, and the fiscal responsibility to ensure timely and accurate coding. Experience directing Outpatient Coding in a multi-facility, multi-state health system would be an asset. Knowledge of CMS’s HOPPS reimbursement methodology as well as Maryland’s HSCRC requirements would be expected.
Full Time, Day Shift
Pay Grade: MK
Bachelor’s degree in Health Information Management required, or work experience equivalent to two years of HIM leadership experience, for one year of education experience, i.e. 8 years..
Required Licensure Certification:
RHIA or RHIT and CCS credential required
Minimum of five to seven (5-7) years of leadership experience in Health Information Management and Coding. Experience in a large academic medical center and multi-facility health system preferred. Prior work experience must include project and/or management experience in a highly automated revenue cycle environment, with demonstrated experience managing Outpatient Accounts Receivable and DNFB. Must demonstrate team-building experience, and process improvement concepts, to positively influence the work environment. Job Title: Manager of Clinic & Outpatient Coding.
Knowledge and Skills:
Ability to demonstrate in-depth knowledge of concepts, practices, compliance, and policies related to Outpatient Coding. Ability to interpret and monitor payer specific requirements to include CMS HOPPS, NCCI and OCE edits, updates and bundling rules, as well as HSCRC regulations is required. Must demonstrate experience with interpreting, translating and communicating LCD and NCD carrier-specific guidelines. Must demonstrate ability to interpret and apply coding and reimbursement differences as governed by state and federal regulations.
Serves as an authority for HIM facility Outpatient Coding and manages functional area responsibilities. · Formulates, communicates, and implements short and long range goals related to facility Outpatient Coding · Provides oversight and direction to Outpatient Coding Supervisors and Coding Specialists in the development and maintenance of Outpatient Coding Policy and Procedures. · Monitors financial targets for Discharged Not Final Billed (DNFB) to meet Accounts Receivable expectations. · Assists in the development of performance standards to ensure the highest level of coding accuracy for quality indicators such as the following: ICD-10 Diagnosis Coding, CPT/HCPCS Coding, Coding Modifiers, and abstracted data. · Develops and monitors individual performance monitoring program, to ensure regular feedback for defined indicators, and accountability program to maintain high quality. · Provides direction and strategies for a quality coding program to meet regulatory compliance, data quality for all indicators with a goal of 95%, and financial expectations for DNFB. · Develops collaborative relationships with Revenue Cycle, Quality Management, Medical Staff and Outpatient Service leaders in the support of mutual goals. · Identifies issues related to quality data, reimbursement, and revenue cycle activities associated with Outpatient Coding and directs resolution of same. · Develops partnership with Clinical and Outpatient Department leaders, and Medical Staff leadership, to address documentation concerns adversely impacting Outpatient Coding. · Participates in hospital projects and administrative processes to represent the interests of HIM Outpatient Coding relative to Compliance, Revenue Cycle, and Quality. · Assists with planning, monitoring, and managing the Outpatient Coding budget · Assists with the management of vendor relationships and related contracts. · Responsible for hiring, termination, corrective action and performance reviews. · Serves as team leader for small projects or workgroups. · Provides high level of customer service and staff training to meet customer service standards.
Johns Hopkins Health System and its affiliates are drug-free workplace employers.
Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.
Johns Hopkins Medicine.