Senior Director, Coding and Clinical Documentation Improvement

Job Description

ECU Health

About ECU Health

ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers practicing in over 180 primary and specialty clinics located in more than 130 locations.

The flagship ECU Health Medical Center, a Level I Trauma Center, and ECU Health Maynard Children’s Hospital serve as the primary teaching hospitals for the Brody School of Medicine at East Carolina University. ECU Health and the Brody School of Medicine share a combined academic mission to improve the health and well-being of eastern North Carolina through patient care, education and research.

Position Summary

• The Sr. Director, Coding/CDI, provides overall operational direction, oversight and subject matter expertise for Coding/ CDI functions across ECU Health Hospitals and ECU Health Medical Group. 
• Responsibilities include Coding, Clinical Documentation Improvement (CDI), Physician Advisor Program, and other Coding/CDI specific activities within ECU Health and the facilities it supports. 
• The Sr. Director, Coding/CDI leads the Coding/Clinical documentation division toward identified outcomes, setting high performance standards, delivering quality services and supporting continual growth.  He/she ensures standardization of systems, consistency in processes and utilization of best practices in all areas of responsibility across all facilities.

Responsibilities

1.  Leadership

• Leads an interdisciplinary workforce of 100+ FTEs to provide competent, efficient, and compassionate care and services. 
• Conveys an image that is consistent with the organization's values.
• Demonstrates the qualities, traits and demeanor that command leadership respect.  Continuously seeks opportunities for different and innovative approaches to addressing organizational problems and opportunities. Develops collaborative relationships to facilitate the accomplishment of identified goals.
• Assures appropriate resources are deployed to projects, work teams, tasks and ongoing work roles which are consistent with respective subject matter expertise.  Works closely with team members to establish expectations and monitor outcomes. 
• Cultivates a climate of teamwork and collaboration.  Promotes and fosters shared governance.  Inspires and motivates team members to achieve excellence.
• Encourages a culture of reward, retention and promotion from within and supports programs of staff recruitment and development to sustain ongoing need for quality workforce. Supports professional and personal development.  Aids in professional development counseling to promote retention and overall employee satisfaction. 

2.  Identifies staff leaders with potential for development and succession planning.

• Administrative Oversight
• Responsible for overseeing growth, development and operational activities related to areas of responsibility.  Develops the strategy, specific goals, objectives, budgets and performance standards, aligning the division's direction and key initiatives with the strategic plan of the health system.  Assures practices are standardized and consistent across the division. Proactively manages significant issues, status of projects, barriers and successes.
• Develops, manages and reports facility and department specific key performance indicators, ensuring achievement of goals.  Actively manages and monitors process, performance and quality.  Seeks opportunities for efficiencies across the system, eliminating redundancies in resources and achieving optimum work flow.  Identifies and implements process improvements to decrease costs and improve service for applicable stakeholders. 
• Coordinates and participates in communication with the IT department to ensure appropriate systems, enhancements, and tools are utilized to effectively manage day to day operations. Participates in various IT related steering committees for initiatives which affect records management and revenue cycle workflows.
• Oversees management of external vendor relationships and monitoring compliance with contracted service level agreements.
• Seeks out and acquires relationships with vendors when needed, negotiating contract terms when appropriate.
• Develops collaborative relationships to facilitate the accomplishment of work goals utilizing interpersonal skills in building, negotiating and maintaining crucial relationships.

3.  Coding/Clinical Documentation-Hospitals/VMG

• Develops and implements the overall strategy for ECU Health Hospitals and ECU Medical Group's Coding and CDI operations.
• Responsible for the management and coordination of coding, auditing and CDI activities within ECU Health, ensuring complete, accurate, timely and consistent coding that adheres to coding and regulatory guidelines.
• Responsible for the strategic alignment and direction of the daily activities and performance of the pre-AR coding activities associated with all patient encounters within ECUH Hospitals and ECUHMG.
• Collaborates with key members of the revenue cycle, physicians, clinical staff and operational leaders to address issues related to documentation, coding accuracy, charge accuracy, unbilled management and denials.
• Develops and implements ongoing education programs for departments, providers and coding staff to ensure coding and documentation accuracy consistent with payor regulations and corporate requirements for coding department and providers.
• Analyzes trends in CMI to determine root cause and address as appropriate.
• Influences process change to support modifications in documentation within the clinical record to assure optimal quality, compliance and accurate reimbursement is achieved. 
• Builds collaborative working relationships between physicians, clinical staff, coding, finance and revenue cycle to improve quality and completeness of documentation of care provided to support coding and charge capture.
• Monitors performance as demonstrated through CMI, CC/MCC capture rate, physician response rate, RAC reviews, HCC's, coding accuracy rates and other financial and quality metrics.
• Responsible for facility charge capture activity within the Emergency Departments across all system hospitals.
• Monitors charging practices and ensures appropriate communication and process design.

4.  Physician Advisor Program

• Works with direct reports and physician advisors to influence and inspire the medical staff to document a comprehensive and accurate picture of a patient's condition while in one of the ECU Health facilities.
• Oversees the performance and activities of the ECU Health physician advisor program.
• Responsible for the development and implementation of both formal and informal education plans for physicians and advanced practice professionals related to documentation.
• Monitors and guides activities related to pre-bill chart reviews both internally and through partnership with external vendor.
• Develops and monitors metrics to determine the effectiveness of the dollars invested in the program.

5.  Other Key Duties

• Must have exceptional organization skills and the ability to manage multiple high priority projects, lead a diverse group of individuals, and communicate effectively at various levels within the organization.

Minimum Requirements

• Bachelor's Degree and 10 years relevant CPT-4 coding and/or ICD-10 diagnosis and procedure coding for outpatient, inpatient, MS-DRG assignment and professional coding experience required.
• Master's Degree preferred.
• Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or Certified Coding Specialist (CCS) required.
• More Than 10 Years Experience in Coding/CDI Field and at least 5 years Management Experience in Coding/CDI field.

General Statement

It is the goal of ECU Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.

Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.

We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicant’s qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.