Director, Inpatient Coding and Compliance

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Job Title:

Director, Inpatient Coding and Compliance

Department:

Health System Shared Services | Financial Administration

Scope of Position
The Director of Coding, Compliance and Clinical Documentation Enhancement is responsible for assuring high quality information collection and reporting systems for medical information management services, including coding, data quality management, and compliance. The information collected and used by medical information management staff is interconnected with the clinical and business systems of the health system and is used for patient care, teaching, research, hospital operations, quality assurance, and reimbursement. Accurate coding and compliance is essential for a financially viable health care organization.
The Director is responsible for managing department staff, programs, policies and activities related to coding services, data quality management, clinical documentation enhancement and Medical Information Management compliance for the health system. Specific areas include University Hospital (including the Ross Heart Hospital, Dodd Hall, ambulatory care provided in McCampbell Hall, Morehouse Medical Plaza and the Eye and Ear Institute), The James (inpatient, OBS, SDS), OSU Harding, and University Hospital East. Assists in planning, organizing and controlling medical record coding services, coding quality and billing accuracy (as related to coding services), and compliance to meet the patient care, teaching, research and administrative needs of The Ohio State University Wexner Medical Center. Effective management of coding and documentation enhancement staff resources is required to support accurate, timely and complete coding information required in the billing cycle.

The Director analyzes performance to assess quality of coding and medical record documentation and prepares recommendations for action based on the results. Monitors effectiveness of data quality program and recommends improvements as necessary. Works with Administrative Director, Coding Data Analyst and Assistant Director of Documentation Improvement to monitor the various business units’ Case Mix Index (CMI) to identify opportunities for improvement in coding. Responds to reports from Coding Data Analyst that identify potential coding errors or inconsistencies. The Director oversees the department’s compliance plan. This includes assuring the plan addresses all aspects of medical information management compliance, including assessment, training, policies and procedures, monitoring and corrective action.
In the absence of the Administrative Director, the Director provides direction, supervision, and support to all Medical Information Management areas and staff. Advises administration, medical and managerial staff regarding specific issues and problems. Provides assistance as needed. Resolves intra-departmental and inter-departmental problems related to coding, documentation and compliance.
 

Position Summary
This position provides administrative direction to the coding services program and clinical documentation enhancement in Medical Information Management. Manages the program for high quality, timely coding of diagnoses and procedures for inpatient and outpatient accounts, using ICD-9-CM, ICD-10-CM/PCS and CPT-4 coding classification systems, to meet the hospitals’ billing system requirements. Manages the abstracting of data elements required for billing (admission type and source, discharge disposition, attending physician). Monitors the results of the