Distinguishing Features of the

Class:

Under general supervision, the Manager, Network Inpatient Coding provides oversight and direction of the activities of the Network Inpatient Coding function (which includes several WMC Health Network locations) and initiatives of the Health Information Management Department at the Westchester Health Network, ensuring coding compliance and training of coding staff and health care staff network-wide. This position also coordinates and evaluates the staff and activities for network-wide coding operations and Clinical Documentation Improvement to ensure accurate and timely coding of inpatient records according to established standards, policies and procedures. Supervision of professional coding and support staff is a responsibility of this position. Does related work as required.

Examples of Work:

(Illustrative Only) Designs and develops programs and procedures to utilize internal employee population and assist in selection and negotiation of staffing vendors; In collaboration with higher level staff, provides direction for all hospital inpatient coding activities and productivity standards required to reach unbilled targets for Network facilities; Meets specified Discharge not Final Billed (DNFB) target for all hospital's inpatient coding population; Plans, organizes, coordinates and evaluates inpatient staffing requirements to meet operational goals; Manages the assignment and schedules of direct reports to ensure a smooth and efficient workflow; Identifies opportunities for efficiencies, reviews and implements as approved; Reviews strategic operating goals, objectives and budgets to predict labor needs and ensure Inpatient coding services meet productivity, timeliness and quality standards to support financial goals of the Network; Reviews operational performance, justification and/or corrective action for the HIM department inpatient staff; Provides guidance and motivation to staff regarding identifying activities/areas where performance can be improved; Ensures collaboration between the Inpatient Clinical Documentation Improvement and Inpatient Coding function; Develops and implements policies and procedures to ensure clear and consistent operations of inpatient coding areas while encompassing departmental and operational needs; Ensures integrity of encoder and abstracting systems by maintenance/revision of data as necessary; Oversees the implementation and ongoing operation or selection of electronic coding or coding documentation software, interfaces with billing systems and workflow changes with computerized patient information; Identifies training needs for inpatient coding and operations staff; Collaborates with Coding Director and Senior Director to schedule and implement training activities as identified, including transition to EHR and ICD-10 code changes; Responds to leadership inquiries regarding inpatient coding; Collaborates with Business Offices and Patient Access to eliminate holds on accounts; Participates in negotiation of vendor contracts to ensure compliance; Reviews and monitors contract services, and ensures network wide and vendor compliance; Reports on issues and makes recommendations for changes.

Required Knowledge, Skills, Abilities and Attributes:

Thorough knowledge of current practices and principles in the field of medical records coding; through knowledge of federal, state and payer specific regulations and policies pertaining to documentation, coding, privacy, and billing; thorough knowledge of all applicable coding systems and updates including

ICD9/ICD-10, CPT4

coding, APC/DRG and CMS compliance requirements and ability to develop processes and procedures to support those requirements; thorough knowledge of local, state and federal regulatory requirements related to coding; ability to communicate concepts to cross-functional departments or teams; ability to effectively collaborate with medical staff and other hospital departments; ability to manage complex projects and resources; ability to solve problems and identify solutions; ability to strategize, plan and implement change; ability to effectively use coding software, including groupers, compliance tools, editors, optimizers and encoders; ability to interpret and analyze coding data, records, reports and performance measures; ability to communicate clearly, both orally and in writing; good judgment; accuracy; initiative; tact; resourcefulness; physical condition commensurate with the demands of the position

Minimum Acceptable Training and Experience:

Either:

(a) a Bachelor's degree

• and seven years of experience in an acute care facility which included coding complex inpatient medical records, appeals and denial management, two years of which was in a supervisory or managerial capacity; or (b) completion of 90 college credits

• and eight years of professional medical records coding experience at an acute care facility which included inpatient coding and appeals/denials management, two years of which was in a supervisory or managerial capacity.

Substitution:

Satisfactory completion of 30 credits

• toward a Master's degree in Medical Records may be substituted on a year for year basis for up to two years of the above experience. There is no substitution for the required two years of supervisory experience.

Special Requirements:

Must possess and maintain current certification as a Registered Health Information Administrator (RHIA) or Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA).

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Special Note:

Education beyond the secondary level must be from an institution recognized or accredited by the Board of Regents of the New York State Education Department as a post-secondary, degree-granting institution.