Health Information Management (HIM) Coding Manager

Sidra Medical and Research Center - Kenexa

Doha, Qatar

Ref: OP511-79

Job description / Role

Employment: Full Time

The Manager - Coding is responsible for planning, organizing, directing and controlling day-to-day operations in the HIM Coding section. S/he collaborates with and educates clinical staff on coding and documentation guidelines. Also, the incumbent communicates with all departments, coding professionals, clinical and medical staff to improved documentation requirements in the Electronic Medical Records (EMR). Requires knowledge of EMR systems for applying codes, validation of codes for accurate assignment based on provider documentation. S/he ensures data quality and optimum reimbursement allowable under Sidras payment systems. The Manager - Coding is responsible for consistency and efficiency in claims processing and data collection to ensure accurate and optimum DRG reimbursement.

Shall provide leadership for process improvement and redesign to improve customer satisfaction, reduce costs and meet departmental and institutional goals and objectives.

KEY ROLE ACCOUNTABILITIES:
- Is responsible for the development and management of productivity measures for coding of EMR with strong focus on balancing quality and compliance productivity.
- Reviews daily workflow processes and balances workload in coding department to meet targets.
- Is responsible for education of all new coders and cross training requirements.
- Monitors and reviews quarterly coding audits to insure 95% or greater accuracy rate. Prioritizes coding functions to assure records are coded within an average of less than five (5) days, coordinating workflow through the coding area as necessary.
- Coaches coding staff on coding expectations and meeting goals related to both quality and productivity.
- Monitors coding productivity and quality to assure timeliness and accuracy of final bill. Assists with physician peer review process including record review, report generation and other duties as needed.
- Monitors daily coding compliance record reviews and recommends appropriate educational program requirements.
- Audits bill hold report daily, following up on any accounts greater than 7 days from discharge date but not yet coded.
- Creates and monitors reports on unbilled due to documentation, charge errors, and registration errors.
- Manages the coding reconciliation processes.
- Maintains the number of DRG / coding changes below Sidras specified threshold.
- Assures codes are supported by provider documentation and initiates appropriate queries based upon other clinical documentation for accurate and reliable data collection and reimbursement.
- Monitors coding systems to ensure optimal performance, recommends upgrades or changes to current system and participates in the selection of new systems.
- Acts as a resource for coding staff as well as serves as a liaison in the organization to address coding related issues and questions.
- Disseminates changes in coding rules regarding correct coding initiative and coding clinics. Monitors changes in laws, regulations and policies that impact clinical documentation, reimbursement and coding to assure compliance.
- Manages the coding / abstracting systems and ensures that appropriate computer systems are updates with the annual code changes and any other associates changes or updates.
- Fosters an environment of team work and excellence within the coding department.
- Promotes morale by effectively communicating goals, standards and coding department requirements.
- Reviews workflow and processes and balances workload in coding department to meeting productivity targets.
- Develops, implements and monitors policies and procedures, guidelines and compliance plan for coding. Ensures coding processes are compliant and efficient.
- Responsible for ongoing quality assessment; performs audits for compliance, maintains the accuracy of coding performed, oversees the capture and analysis of data regarding operational performance and quality control, ensures all coding is completed with quality and regulatory compliance as the primary objective.
- Ensures timely, accurate, and complete clinical data for billing, reimbursement, utilization and patient information systems.
- Works cooperatively with revenue cycle departments, registration, and scheduling, case management, coding coordinators, coders, coding reconciliation specialists and compliance officer to resolve coding/billing issues.
- Is responsible for validation of clinical data and statistical reports for clinicians, researchers, finance and business planning and quality support services which is used to measure hospitals efficiency, quality assurance program, administrative planning and for national reporting.
- Works closing with finance to establish Accounts Receivable (AR) goals and maintains AR days at an acceptable level and track the Days Not Final Billed (DNFB).
- Oversees coding education by preparing and completing materials for internal and external audits, regulatory changes and medical research advancements.
- Serves as a member in designated committees such as Revenue Cycle Steering Committee, plays a key role in denials management and process improvement projects.
- Manages and monitors operating budget in the coding department.
- Adheres to Sidras standards as they appear in the Code of Conduct and Conflict of Interest policies

In view of the evolving needs and opportunities within Sidra during this pre-operational phase, this position may be required to perform other duties as assigned and reporting relationships may vary.

Requirements

- Bachelors Degree in a related field
- Experience 5+ years of management experience
- RHIT, Clinical coding Specialist (CCS)
- All aspects of HIM coding
- Proficient in ICD10 and CPT coding for inpatient, outpatient, ambulatory surgery, observations, emergency department visits, and ancillary services
- Revenue Cycle
- Proficiency with Microsoft Office suite
- Fluency in written and spoken English

About the Company

Sidra Medical and Research Center will be an ultramodern, all-digital academic medical center which will set new standards in patient care for women and children in Qatar, the Gulf region and internationally.

It will encompass three essential missions:

World-Class Patient Care Medical Education Biomedical Research

Sidra will work closely with its academic partner Weill Cornell Medical College in Qatar (WCMC-Q) and Hamad Medical Corporation in regard to all three missions, raising the standard of health care throughout the country and providing valuable opportunities for research and learning. Sidra is part of a dynamic research and education environment in Qatar that includes leading international institutions, such as Georgetown University, as well as other newly established national research centers.

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