PRN Clinical Coding Reimbursement Compliance Manager

Harris Health System

Houston, TX

JOB DETAILS
SKILLS
Acute Care, Anatomy, Auditing, Billing, Cancer, Certified Coding Specialist (CCS), Communication Skills, Community Health, Corporate Compliance, Data Quality, Diagnosis-Related Group (DRG), Disease Prevention and Control, Documentation, Health Science, Healthcare, High School Diploma, Hospital, ICD-10, Maintain Compliance, Medical Billing, Medical Coding, Medical Terminology, Medicine, Microsoft Access Database, Microsoft Excel, Microsoft Word, National Committee for Quality Assurance (NCQA), Nursing, Outpatient Care, Patient Care, Physiology, Presentation/Verbal Skills, Primary Care, Public Health, Public Safety, Quality Management, Reimbursement, Telemedicine, Time Management
LOCATION
Houston, TX
POSTED
30+ days ago

Harris Health System is the public healthcare safety-net provider established in 1966 to serve the residents of Harris County, Texas. As an essential healthcare system, Harris Health champions better health for the entire community, with a focus on low-income uninsured and underinsured patients, through acute and primary care, wellness, disease management and population health services. Ben Taub Hospital (Level 1 Trauma Center) and Lyndon B. Johnson Hospital (Level 3 Trauma Center) anchor Harris Health's robust network of 39 clinics, health centers, specialty locations and virtual (telemedicine) technology. Harris Health is among an elite list of health systems in the U.S. achieving Magnet nursing excellence designation for its hospitals, the prestigious National Committee for Quality Assurance designation for its patient-centered clinics and health centers and its strong partnership with nationally recognized physician faculty, residents and researchers from Baylor College of Medicine; McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth); The University of Texas MD Anderson Cancer Center; and the Tilman J. Fertitta Family College of Medicine at the University of Houston.

Job Summary

Working with the Vice President/Deputy Compliance Officer and Director Compliance and Audit for Corporate Compliance, this position is responsible for developing, implementing and maintaining a data quality compliance plan for hospital inpatient/outpatient coding and reimbursement. The person in this position is responsible for development of standards, policies, and procedures as well as education and training programs regarding elements of the HIM coding compliance. This includes documentation and accurate coding to all appropriate personnel, including HIM coding staff, physicians, billing personnel and ancillary departments. This person will also coordinate and conduct review of targeted areas to assume timely billing process, correct hospital reimbursements and perform random audits to validate accuracy of DRG, APC, and other coding to ensure compliance with coding and billing requirements.

Minimum Qualifications

Degrees / Work Experience / School Education:

Bachelor's Degree (And) Five (5) Years Work Experience coding management experience in a large acute care hospital setting.

(Or)

High School Diploma or GED (And) Nine (9) years work experience coding management experience in a large acute care hospital setting.

Licenses & Certifications:

Certified Coding Specialist (or) CCS-P from AHIMA

Certified Inpatient Coder (CIC)

Management Experience: Five (5) years management experience

Communication Skills: Exceptional Verbal (e.g., Public Speaking)

Proficiencies: MS Access, MS Excel, MS Word, P.C.

Job Attributes

Work Schedule: Eligible for Telecommute

Other Requirements:

Must have a strong background in ICD-10-CM Classification systems, knowledge of anatomy and physiology, clinical medical and medical terminology, along with excellent working and current knowledge of federal and the All-Payer DRG reimbursement methodology for hospital (facility) billing.

About the Company

H

Harris Health System

Harris Health is a nationally recognized health system comprising three teaching hospitals and an extensive network of ambulatory care centers serving the people of Harris County, Texas, since 1966. Staffed by the faculty, fellows and residents from two nationally ranked medical schools, Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth), Harris Health is the first healthcare system in Houston to receive the prestigious National Committee for Quality Assurance (NCQA) designation for its network of patient-centered medical homes. Each year, Harris Health provides more than 1.8 million total outpatient visits through its more than 40 ambulatory care facilities. Additionally, Harris Health sees more than 177,000 emergency visits at its Level 1 and Level 3 trauma centers and 35,000 hospital admissions through its three hospitals: Ben Taub, LBJ and Quentin Mease. Established by voter referendum to enhance the level of charity care available in the community, Harris Health System has often received national recognition for serving those in need and for its achievements in operational excellence, such as being named to the 2011, 2012, 2013 and 2014 Most Wired Hospitals lists by the American Hospital Association's Hospitals & Health Networks magazine. Additionally, Harris Health System is pleased that each of its three hospitals: Ben Taub, Lyndon B. Johnson and Quentin Mease - achieved Pathway to Excellence designation by the American Nurses Credentialing Center.
COMPANY SIZE
5,000 to 9,999 employees
INDUSTRY
Healthcare Services
FOUNDED
1966
WEBSITE
https://www.harrishealth.org/en/pages/home.aspx