Director of Coding - Health Information - F/T Days

Who We Are

UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. UCI Health is comprised of its main campus, UCI Medical Center, a 459-bed, acute care hospital in in Orange, Calif., four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los Angeles counties and ambulatory care centers across the region. Listed among America's Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and quaternary care and is home to Orange County's only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County.

To learn more about UCI Health, visit www.ucihealth.org.

Your Role on the Team

Position Summary:

The Director, Coding is responsible for the operational leadership and management of all inpatient and outpatient coding functions. The incumbent is accountable for the clinical quality, operational performance, regulatory and payer compliance, and financial management of coding services, encompassing ICD-10-CM/PCS diagnosis and procedure coding, CPT coding, DRG validation and optimization, coding quality and audit functions, coding compliance, and clinical documentation integrity. This role directs departmental activities to ensure coding services are delivered accurately, efficiently, and in alignment with health system standards, regulatory requirements, and organizational objectives, supporting the integrity of the medical record, revenue cycle performance, and compliance with all applicable federal and state coding and billing guidelines. The Director serves as the primary subject matter expert and operational resource for all matters related to inpatient and outpatient coding, coding compliance, payer requirements, and coding technology systems, and collaborates with clinical, physician, HIM, compliance, revenue cycle, and administrative leadership on coworker development, technology and information systems planning, denial management, coding accuracy improvement, and performance improvement initiatives. This position provides direct oversight and serves as a role model and primary resource to coworkers and others, maintaining accountability for departmental performance and the financial integrity of coding operations. The Director exercises wide latitude of authority in managing facility-level and operational coding functions with limited oversight.

What It Takes to be Successful

Preferred Qualifications:

• Strong knowledge of the ICD-10 Official Coding Guidelines for Coding and Reporting, UHDDS definitions, AMA CPT and Modifier rules, bundling rules and documentation requirements for medical necessity set forth in associated Medicare NCD or LCD's
• Project management and advance software skills
• Possesses broad knowledge of various medical specialties and appreciates the complexities of subspecialty coding practices
• Must possess the skill, knowledge, and ability essential to the successful performance of assigned duties
• Must demonstrate customer service skills appropriate to the job
• Knowledge of CMS's HCC hierarchies and risk adjustment models and HEDIS reporting, ROI
• In-depth knowledge of professional clinical coding & reimbursement topics and experience with electronic medical records
• Must be CCS Certified and have detailed coding experience
• Knowledge and experience with compliance query guidelines, denial management and price transparency requirements
• FaFamiliar with Population Health-based metrics, including PQRS, MIPS and VBM merit-based incentive payment systems
• Excellent leadership and fiscal management skills and ability to create a goal-oriented climate of teamwork, collaboration, and consistent achievement of objectives
• EPIC expertise and knowledge, including Coding and workflow routing as related to EPIC
• Demonstrates advanced written and verbal English communication, interpersonal, organizational, analytical, and presentation skills.
• Demonstrated excellent critical thinking and problem-solving abilities, including the ability to assess and evaluate operations, produce and interpret reports, develop new policies and strategies, and implement plans
• Demonstrated ability to present to large groups/conferences (such as AHIMA)
• Bachelor's degree in Health Information Management or related field and/or equivalent experience/training
• Ability to maintain a work pace appropriate to the workload
• Ability to leverage technology to create greater efficiencies and establish related tracking and audit procedures
• 7 years related work experience with extensive management experience in ICD-10-CM, DRG and CPT-4 coding of inpatient and outpatient records in an acute care facility and experience in using a computerized abstracting, encoding, and database systems
• Minimum 5 years' experience of progressive management responsibility
• Minimum of 3 year experience in an management leadership role

Total Rewards

We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits.