The Clinical Coding Manager plans, organizes, directs, and controls the day-to-day operations within the Clinical Coding Section of the Health Information Management Services (HIMS) Department in a manner that encourages teamwork to meet the mission and vision of CCAD and the Revenue Cycle Management (RCM) Department.
Primary Duties & Responsibilities
• Plans, organizes, directs, and supervises the operations of the Clinical Coding Section within the HIMS Department in a manner that is compliant and efficient.
• Provides leadership for process improvement and redesign to improve customer satisfaction, reduce costs, and meet departmental and institutional goals and objectives.
• Coaches coding staff and effectively communicates goals, standards, and needs on coding expectations and meeting goals related to both quality and productivity.
• Conducts performance evaluations and counsels employees in performance improvement, conflict resolution, and disciplinary actions.
• Manages and monitors the operating budget for the Clinical Coding Section.
• Reviews workflows and processes and develops, implements, and monitors procedures, guidelines, and coding compliance plans for the Clinical Coding Section to meet targets for completion of coding.
• Generates and submits reports on the Clinical Coding Section Key Performance Indicators (KPI)
• Acts as a resource for the Clinical Coding staff as well as serves as a liaison in the organization to address clinical coding related issues and questions.
• Assists the Director of HIMS in developing and implementing training for new Coding Technicians and coordinates with the Training Coordinator in the implementation of clinical coding training.
• Informs the Coding Technicians of internal and external audits and prepares performance improvement plans based on the audit results.
• Monitors and disseminates changes in Health Authority Abu Dhabi (HAAD) correct coding of initiatives; AHA Coding Clinic; CPT Assistant; and, other laws, regulations, and policies that impact clinical documentation, reimbursement, and coding to ensure compliance.
• Benchmarks performance and/or standards against local international standards.
• Performs routine coding quality audits for compliance to the HAAD mandated coding standards for diagnosis, procedure, and Evaluation & Management level assignment.
• Oversees the Clinical Documentation Improvement (CDI) program within the HIMS Department and reports to the Director, HIMS on issues related to documentation.
• Collaborates with the Coding Support Specialist and Training Coordinator in physician and clinical staff education on coding and documentation guidelines.
• Maintains Account Receivable (AR) days at an acceptable level and tracks Discharged Not Final Billed (DNFB) accounts.
• Works closely with Managers of other Revenue Cycle Management (RCM) Departments to create efficiency and consistency in claims processing and data collection to optimize reimbursement.
• Monitors the number of IR-DRG, diagnosis, procedure, and E&M changes.
• Monitors coding systems to ensure optimal performance and recommends upgrades or changes to the system to the Director, HIMS.
• Participates in the Health Information Management Services (HIMS) Committee and reports on issues related to coding compliance with applicable standards and guidelines.
• Ensures staff within their assigned sections attends technical and mandatory training/education.
• Maintains confidentiality of patient’s protected health information (PHI) in both electronic and paper formats.
• Participates in clinical coding of all account types as needed.
• Performs other duties as assigned.
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