Work Shift:
8 Hours - Day Shifts (United States of America)
Scheduled Weekly Hours:
40
Compensation:
Salary Range: $67.00 - $110.50
Union Position:
No
Department Details

Summary
Responsible for overall design, implementation and optimization of hospital and professional coding for Sanford Health.

Job Description
Provides leadership in the areas of clinic and hospital professional coding, hospital inpatient and outpatient facility coding, and hospital and professional denials/audits. Provides strategic planning and technical leadership and input on information systems. Directs and provides leadership to hospital and professional coding staff. Directs the processes and resolution of clinic and hospital professional coding and hospital facility related denials.

Provides direction and leadership for denial management and audit activity to include integrity of appeal process and policy. Demonstrates ability to develop, evaluate, monitor, educate, and analyze health system coding processes on a daily basis to increase productivity, ensure compliance is met utilizing all recognized coding guidelines and all payor policies and guidelines and the goals of Sanford Health are met.

Responsible for operational budget and strategic initiatives and formulation of Sanford Health's coding operating model and enhancement of coding related services throughout the system in order to drive and meet the goals of revenue services. Organize and streamline operations to achieve financial and service objectives. Develop and manage a multi-million dollar annual budget. Work extensively with IT. Develops reporting tools for Sanford leadership to help in fiscal budget planning and decision making, as well as education to reduce denial/RAC activity for the system.

Collaborates and coordinates with various Sanford Health leaders to ensure coding integrity and accurate data collection is achieved to support a seamless continuum of care, supporting provider compensation models, compliant processes, optimal reimbursement and efficient revenue cycle functions. Strengthens relationships by communicating department activity and outcome with other managers and service areas.

Participate in revenue cycle strategies and initiatives. Demonstrate vision and leadership in strategic planning and manage multiple competing priorities and diverse viewpoints. Lead by example, with initiative, self- discipline, confidence and professionalism to encourage and enable a management team and staff.

Sets vision and direction for developing and maintaining relationships between the Sanford provider community and coding. Supports Sanford's efforts to influence public policy at the state and federal levels.

Must demonstrate a broad-based knowledge of coding and billing practices.

Qualifications
Bachelor's degree required.

Minimum seven years of directly related work experience and extensive knowledge of basic and underlying Current Procedural Terminology (CPT) coding practices required.

Minimum seven years of management experience in a large health care system with responsibility for coding practices.

Additionally, possess extensive knowledge of state and federal laws, rules and regulations and must be able to accurately interpret and apply these laws, rules and regulations. Experience in health care finance, rate setting procedures, and intermediary auditing related to Medicare. Experience analyzing and maximizing third party reimbursement, and experience with computerized reporting systems.

Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Outpatient Coder (COC) or Certified Coding Specialist (CCS) certification required.