[Hiring] Director, PB Coding Operations & Education @BMC Software

Role Description

The Director PB Coding Operations and Education functions primarily on providing coding oversight and standards to ensure coding accuracy, compliance and appropriate reimbursement across BUMG, along with managing operational execution of these standards in areas reporting to Revenue Cycle.

The Director has responsibility for managing coding operations and overall success of an effective program, including oversight for coding training across BUMG.

The Director manages coding staff to ensure compliance with coding guidelines, regulatory agencies and that appropriate reimbursement is received for the level of service rendered.

Essential Responsibilities / Duties

• Facilitate accurate representation of professional coding and clinical documentation through interaction with physicians, coders and practice staff by providing ongoing education.
• Direct coding activities to ensure accurate, consistent and compliant coding for all services.
• Ensure quality reviews to validate coding accuracy.
• Participate in the rejections, denials and claims review process with billing team to ensure compliance and accurate reimbursement.
• Identify trends in documentation and coding concerns and collaborate with Leadership and Compliance to assess and implement corrective action.
• Evaluate the success of coding processes on an ongoing basis.
• Serve as contact for professional coding across BUMG.
• Work with Human Resources and department managers on the selection of qualified candidates for employment following all policies, guidelines and applicable laws.
• Responsible for effective personnel management including training, directing, mentoring and instilling a commitment to quality and excellence.
• Monitor department productivity and performance to identify and evaluate program/department strengths and training opportunities in relation to operative effectiveness.
• Encourage staff and personally advance professional growth and development through participation in educational programs, workshops and maintaining knowledge of industry standards and practices.
• Must adhere to all of BMC’s RESPECT behavioral standards.

Qualifications

• Bachelor’s degree or equivalent combination of formal education and experience.
• CPC – Certified Professional Coder.

Requirements

• Minimum of 10 years related experience in professional coding with ICD-9/ICD-10, E/M and CPT.
• Previous management experience required; experience must include education/mentoring/training.
• Expertise knowledge of ICD-9/ICD-10, CPT and E&M coding principles and guidelines.
• Knowledge of MS, AP, and APR DRG systems APG, EAPGs.
• Knowledge of payer reimbursement methodologies, federal, state and payer specific regulations, policies and compliance standards.
• Excellent written verbal and communication skills.
• Excellent critical thinking skills.
• Excellent skill in providing hands-on education to providers including audit findings and improvement opportunities.
• Excellent organizational skills, including ability to multi-task, prioritize essential tasks, follow-through and meet timelines.
• Ability to work cooperatively with members of the healthcare delivery team and staff.
• Ability to adapt to changes in workload and priorities, responding quickly to urgent requests.
• Ability to mentor, guide and motivate direct reports through demonstration of best practices and leading by example.

Benefits

• Compensation Range: $122,000.00 - $177,000.00.
• Generous total compensation that includes benefits (medical, dental, vision, pharmacy).
• Discretionary annual bonuses and merit increases.
• Flexible Spending Accounts.
• 403(b) savings matches.
• Paid time off.
• Career advancement opportunities.
• Resources to support employee and family well-being.