Responsible for maintaining administrative, operational, and technical aspects of the Inpatient MS-DRG (Medicare Severity Diagnosis Related Groups) Coding Operations. Ensures that Coding is completed in established time frames to maintain financial stability of the organization.
EDUCATION: High School graduation or equivalent; Bachelors degree preferred.
EXPERIENCE: 5 Years inpatient coding experience, experience with MS-DRG (Medicare Severity Diagnosis Related Groups) grouper preferred. 3 years experience with clinical information systems (3M grouper, Soft- Med, Electronic Medical Record, etc.). 3 Years operational and/or supervision experience preferred.
LICENSE/CERT/REG: CCS (Certified Coding Specialist) certification. RHIT (Registered Health Information Technician) or RHIA (Registered Health Information Administrator) preferred.
SKILLS: Excellent verbal and written communication skills. Basic computer skills required. Clinical system software skills (3M, electronic medical record, etc.). Data evaluation and analysis experience. Strong knowledge of DRG (Diagnosis Related Groups) payment and regulatory systems. Supervisory skills.
Primary Duties and Responsibilities
Adheres to all compliance regulations and maintains annual compliance education. Maintains credentials required for job classification.
Assists in developing and adhering to operating budget. Holds associates accountable to all department personnel policies. Maintains compliance with other departmental policies and procedures, as well as government and accrediting agency regulations.
Coordinates computer system downtime with IT and staff members.
Develops and contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards. Ensures compliance with hospital/facility policies and procedures and governmental/accreditation regulations.
Establishes and maintains relationships with contracted companies.
Implements and maintains abstracting system. Responsible for data integrity of abstracted data to ensure accurate submission. Monitors IT validation reports to ensure accuracy of data reported.
Maintains appropriate coverage and associate workload.
Monitors bill holds to maintain financial stability of organization.
Monitors coding productivity and coding quality reports for assigned hospitals and holds associates accountable for their performance.
Oversees the reconciliation process for any internal or external department coding reviews (core measures, CDI, MHACs, etc.) to ensure compliance.
Participates in multidisciplinary quality and service improvement teams as appropriate. Participates in meetings, serves on committees and represents the department and hospital/facility in community outreach efforts as appropriate.
Performs other duties as assigned.
Performs timely assessments of competency of staff. Responsible for completing all Talent Manager Reviews and setting individual staff goals.
Responsible for payroll approval for assigned staff.
Selects, trains and orients department staff. Develops and maintains succession plans and actively recruits.
Serves as a liaison between the Inpatient MS-DRG (Medicare Severity Diagnosis Related Groups) Operations department and other hospital departments for all issues related to coding activity.
Serves as a resident expert on coding and interacts with hospital departments for educational purposes regarding coding guidelines and principles. Maintains relationships with Corporate Coding Director, Coding Quality Director and CDI (Clinical Documentation Improvement) Director to establish consistent coding guidelines and coding practices.
Works closely with PFS/LMRP Manager for timely resolution.
Works with Coding Educator to identify areas for educational opportunities and other staff development activity. Promotes credentialing and professional growth.
About MedStar Health
MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation and research. Our 30,000 associates and 5,400 affiliated physicians work in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest visiting nurse association in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar is dedicated not only to teaching the next generation of doctors, but also to the continuing education and professional development of our whole team. MedStar Health offers diverse opportunities for career advancement and personal fulfillment.