Associate Director, Outpatient Medical Coding

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Job Title:

Associate Director, Outpatient Medical Coding

Department:

Health System Shared Services | MIM CDI and Coding

Scope of Position

The Associate Director of Outpatient Coding Services performs at an expert level sustaining responsibility for timely and accurate coding of all facility outpatient visits and outpatient coding audits for The Ohio State University Wexner Medical Center (OSUWMC) including James Hospital. This position oversees the operations of denials, claim edits, and charge capture for reimbursement purposes. In this role, the Associate Director of Outpatient Coding Services serves as a liaison and coordinator for special projects regarding the coding of medical records.

This position develops and implements policies and procedures to achieve organizational goals; and assists in the development of operational strategy. This position also re-evaluates processes to keep staff engaged and to assist in meeting department and organizational goals for OSUWMC.

This position is critical to the financial and legal standing of the hospital for compliance and legal purposes. The director shall assist in planning, organizing, staffing, and directing the outpatient coding area to ensure any outstanding accounts are properly coded and billed. The Outpatient Associate Director is responsible for monitoring employee training, productivity, quality, and overall employee performance of all Outpatient Medical Record Coding Specialists, Failed Claims Specialists, Charge Capture Specialists, and MIM Student Interns.

This job role requires advanced clinical documentation review to educate providers, nurses, department leads/senior management, finance teams, and other stakeholders. The clinical documentation review the Coding Managers perform is critical to ensuring coding accuracy, compliance, and possible revenue optimization.

In addition, the Associate Director of Outpatient Coding Services is responsible for allocating work assignments for claims that fail and conducts focused and random audits of medical

records for both coding as well as compliance Outpatient Code Editor (OCE), National Correct Coding Initiative (NCCI) and Medicare Code Editor (MCE) edits as requested by the central business office (CBO).

To achieve goals and financial metrics, the director works in collaboration with various OSUWMC health system operational leaders, and the manager collaborates/networks with external vendors, external consultants, consulting team members and/or matrixed staff as required in support of hospital initiatives.

Position Summary

This role serves as the Associate Director for outpatient coding services, and compliance which includes, student interns, medical record coding specialists, and failed claims specialists. This team is vital to the continued operation of the entire Department as it serves to assign the codes necessary for the billing of the outpatient visit. Sets daily priorities, monitors accounts not coded, trains and supports coding specialists in assigning ICD-10-CM diagnoses, Hierarchical condition category (HCC) coding, operationalize SDOH, assign procedure codes (CPT-4), and determines APC…