Director, Revenue Management Coding Operations

Location: Buckhorn Office Building

Department: Finance

Work Schedule:  Days

Work Type: Full Time  

Job Summary:

This position oversees and directs the team responsible for ensuring correct coding across the system. This includes providing direction for Professional Coding staff as organized by Service Line in regards to the timely processing of discharges system-wide for both professional and hospital services associated with Geisinger Health System. This position is primarily responsible for coding quality improvement and staff education. Coding Director is responsible for ensuring accuracy of coding assignment using random auditing methodology. Responsible for responding to requests from the Central Business Office regarding medical record investigation for outpatient/inpatient billing due to claims holding for the National Correct Coding Initiative (NCCI), Outpatient Code Editor (OCE), or any other payor edits. The position is further responsible for providing feedback to the AVP, Revenue Management Coding Operations and Director of Compliance regarding coding quality and taking the necessary steps to improve accuracy in coding. This position also communicates coding processes and program status regularly through mass communications to physicians, clinical operations staff, and leadership.

This position provides expert knowledge about issues like HIPAA and various performance improvement efforts within the organization. Further this position will lead quality improvement teams related to Revenue Management Coding Operations. Understanding of healthcare finance, outcomes analysis, and continuous quality improvement are also essential knowledge bases. Knowledge of applied statistics, data quality, and integrity measurement techniques such as data mining, data warehousing, and database management tools is critical.

Reports to the AVP, Revenue Management Coding Operations.

Competencies and Skills:

Demonstrates strong presentation skills with the ability to effectively communicate to many different audience levels.

Demonstrates extensive knowledge of revenue management and/or regulatory requirements as they relate to the hospital and professional coding operations components of revenue management and the effect on overall financial health required.

Demonstrates strong analytical ability and proficiency with automated Patient Accounting systems and their related applications and structure (Siemens' INVISION, IDX BAR), payers, providers, hospitals and physicians. A strong understanding of the following required:

a. Requirements for facilitating accounts receivable resolution

b. Customer service issues related to incomplete medical records

c. Inpatient and outpatient medical record chart flow

d. Coding processes

e. Cash flow

Education and or Experience:

Associate's degree or Bachelor’s degree in Healthcare, Finance, Business Administration or related field required. Master’s degree in related field preferred.

CPC/CCS/RHITor equivalent required. Minimum of eight (8) years of experience as a Coding Supervisor or Coding Quality Manager in a similar setting required.

Demonstrates extensive knowledge (i.e. minimum of nine years) of revenue cycle and/or regulatory requirements as they relate to the hospital and professional coding operation components of the revenue cycle and the effect on overall financial health required. Must have an understanding of an integrated delivery healthcare system. Multi-hospital system experience preferred.

Working Conditions/Physical Demands:

Work is typically performed in an office environment.

The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. 

The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.

ABOUT GEISINGER: Geisinger is a physician-led health system comprised of approximately 30,000 employees, including nearly 1,600 employed physicians, 13 hospital campuses, two research centers, and a 583,000-member health plan Geisinger is nationally recognized for innovative practices and quality care. Geisinger serves more than 3 million people in central, south-central and northeast Pennsylvania and also in southern New Jersey with the addition of National Malcolm Baldridge Award recipient AtlantiCare, A member of Geisinger. In 2017, the Geisinger Commonwealth School of Medicine became the newest member of the Geisinger Family.

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.* Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. For more information, visit www.geisinger.org, or connect with us on Facebook, Instagram, LinkedIn and Twitter.

** Does not qualify for J-1 waiver.  We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply.  All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.

*Domestic partner benefits not applicable at Geisinger Holy Spirit.