Major Responsibilities:Manages oversight of all Epic and claims manager system operational functions which include but are not limited to, edit creation and maintenance, PB and HB Epic coding workflow redesigns, Epic upgrades, EAP builds (code setups), along with work queue maintenance and testing.Has direct oversight of Computer Assisted Coding system operations. Works with HIT and vendors to ensure all software and interfaces are up to date, functional and have limited delays.Serves as Coding Systems Representative on all Revenue Cycle and HIT collaboration committees for the system to ensure standardization of practice and build. Annually review all edits, rule and work queue assignments for accuracy and appropriateness. Works with HIT to reassign or approve changes.Identifies, maps, measures, analyzes and improves clinical and business processes, problems and requirements for assigned HIM and Coding System application(s). Performs current and future workflow analysis and maps our critical business processes using industry standards and best practices. Develops test plans, test cases and test scripts to validate performance of clinical/business functions. Conducts effective unit, integration and end-user acceptance testing through execution of the tests, tracking of problem reports and documenting final outcomes.Facilitates clinical/business practice processes which result in successful software transitions and system utilization. Identifies and analyzes opportunities for application product development, optimization and technical improvements/changes that foster streamlined and integrated workflows. In collaboration with information technology, translates user requirements into functional design specifications and reviews with users to ensure accuracy. Ensures accurate data maintenance and reviews the technological impact of business requirements.Manages and develops process documentation including current system guidelines, workflows, requirements, functional specifications, installation instructions, product test procedures, user manuals, procedures and troubleshooting guidelines. Completes change and quality control documentation using department standards. Reviews data integrity and audit reports to identify/resolve potential issues and analyzes opportunities for system process improvements and/or product development. Collaborates with information technology to implement changes. Performs data analysis to support data requirements and initiatives.Manages development of end user training/education modules and delivers training on system capabilities/functionalities as appropriate to the product or application and related systems. Assists users in using the full functionality of the application(s) and process flow. Evaluates training effectiveness, maintains and updates training curriculum as needed. Consults with leadership, team members and other revenue cycle partners to identify problems and resolutions related to equipment, applications and/or functionality. Provides input into project timelines. Ensures projects are completed successfully within deadlines.Develops tools, definitions and reports as requested by HIM Operations and Coding. Ensures that data reported externally to state associations per statute is accurate and timely. Provides analytical, technical and problem resolution. Independently investigates complex problems. Evaluates application effectiveness and/or performance, identifies potential risks and proactively resolves issues.Serves as Chair of the Epic HIM & Coding Standards workgroup to review potential Epic changes impacting HIM Operations and Coding, review requests for new Epic encounter/note/document types and/or specialties and other Epic related updates.Participates in strategic planning process and implements goals to support the overall organizational strategic plan. Develops and recommends operating and capital budgets and controls expenditures within approved budget objectives.Performs human resources responsibilities for staff which include interviewing and selection of new employees, promotions, staff development, performance evaluations, compensation changes, resolution of employee concerns, corrective actions, terminations, and overall employee morale.Develops and recommends operating and capital budgets and controls expenditures within approved budget objectives.Responsible for understanding and adhering to the organization's Code of Ethical Conduct and for ensuring that personal actions, and the actions of employees supervised, comply with the policies, regulations and laws applicable to the organization's business.
Licensure, Registration, and/or Certification Required:Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA), or Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA), or
Education Required:Bachelor's Degree in Health Information Management or related field.
Experience Required:Typically requires 5 years of experience in coding, health information management and/or compliance for large complex health care systems. Includes 1 year of supervisory experience in management of staff, overseeing of budgets and multiple health information functions.
Knowledge, Skills & Abilities Required:Demonstrated knowledge of physician, hospital and home health coding systems.Demonstrated skills in financial and statistical analysis necessary to examine revenue cycle/reimbursement activities and detect/resolve any related issues.Demonstrates extensive knowledge of third party reimbursement programs, state and federal regulatory issues, national and local coverage decisions, research related restrictions, and ICD-9/ICD-10, CPT/HCPCS coding classification systems.Demonstrated proficiency in Epic and other databases, the Microsoft Office Suite (Word, Excel, PowerPoint) or similar products and in patient accounting and billing systems.Ability to work effectively with multiple departments and in matrix organizational structures.Strong presentation and interpersonal skills. Ability to present ideas in user-friendly language and to influence others to move towards consensus on critical decisions.Ability to identify and solve problems creatively and to work within deadlines with a high attention to detail.Excellent communication skills with all levels of team members and physicians.Excellent organization, prioritization and time management skills.
Physical Requirements and Working Conditions:Generally exposed to a normal office environment.Position requires travel, therefore, may be exposed to severe road and weather hazards.Operates all equipment necessary to perform the job.
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.