"Revenue Cycle Coding Director - Professional Coding"

The Director of Professional Coding provides strategic and operational leadership for all professional coding activities across a multi-hospital integrated health system. This role ensures consistency, standardization, regulatory compliance, and high-quality outcomes in professional coding functions within the Revenue Cycle, aligning operations with the health system's mission and values.

The Director leverages data-driven insights, industry best practices, and team leadership to drive continuous improvement, maximize net revenue, ensure regulatory adherence, and support operational growth across the enterprise.

Characteristics, Duties, & Responsibilities:

LEADERSHIP

• Leads and develops a regional team of skilled coders, fostering a culture of excellence, collaboration, and ongoing growth.
• Build a high-performing environment aligned with the organization's core values and strategic goals.
• Develops collaborative relationships with leadership, clinical staff, and revenue cycle teams to meet established objectives.
• Establishes clear expectations, provides performance feedback, and supports ongoing professional development.
• Champions strategies to retain, reward, and promote staff, supporting training and career advancement.
• Maintains personal competency and knowledge in professional coding, actively participating in relevant professional organizations.
• Represents the professional coding division on institutional committees as appropriate.

OPERATIONS AND PROCESS IMPROVEMENT

• Oversee all aspects of professional coding operations, ensuring accurate and compliant assignment of ICD-10, CPT, and modifier codes for provider services.
• Develops, implements, and refines policies, workflows, and procedures for professional coding to ensure regulatory compliance and performance metrics.
• Monitors and reports on coding quality, productivity, accuracy, and other key performance indicators, using data to guide decision-making.
• Collaborate with IT and other stakeholders to enhance EHR and coding support systems.
• Leads process improvement initiatives to increase efficiency, accuracy, and compliance in professional coding, reducing denials and improving revenue capture.
• Manages vendor relationships related to coding services and guarantees compliance with service-level agreements.
• Communicates and effectively implements program and process changes, leading change management as needed.

STAKEHOLDER ENGAGEMENT

• Build collaborative relationships with physicians, clinical documentation improvement (CDI) teams, revenue cycle partners, and operational leaders to enhance documentation and coding outcomes.
• Provides guidance and consultation on documentation and coding to boost reimbursement and data integrity.
• Works with stakeholders to resolve coding issues that impact quality, reimbursement, and compliance.

PROBLEM SOLVING & STRATEGIC MANAGEMENT

• Identifies barriers and opportunities for improvement within the coding function, leading solutions through Lean methodology and project management best practices.
• Manages and prioritizes multiple projects and initiatives, ensuring they support organizational goals.
• Anticipates risks or concerns related to coding quality, regulatory changes, or payer requirements, and implements actions to address them.

Required Qualifications:

• Bachelor's degree in Health Information Management, Healthcare Administration, or related field required.
• Active certification as a Certified Professional Coder (CPC), Certified Coding Specialist - Physician-based (CCS-P), or equivalent required.
• Minimum 7 years of professional coding experience in a multi-specialty or academic medical center environment.

Preferred Qualifications:

• Advanced degree (MBA, MHA, or equivalent) preferred.
• Additional credentials (such as RHIA, RHIT, or specialty coding certifications) are desired.
• 5+ years of leadership experience overseeing professional coding within an academic medical center setting.
• Proficiency with electronic health record (EHR) systems and coding software.
• Proven knowledge of federal and state coding, billing regulations, and compliance best practices.