System Director Revenue Cycle – Coding, Documentation and CDI

M Health Fairview

Job Description:

The System Director of Coding, Documentation and CDI is a key member of the Revenue Cycle Leadership Team. This position provides overall strategic and operational direction and oversight of patient, provider and workforce-centric services for technical and professional coding operations and clinical documentation integrity. This role leads a culture of continuous improvement including the associated analysis, quality assurance and education for the team and its customers. This position also provides overall strategic and operational direction and oversight for system-wide standardization regarding coding and documentation integrity, timely and accurate work, communication, and experience ensuring services are efficient, effective, compliant, trusted, timely and convenient. This is a key leadership role in setting standards and ensuring regulatory and payer requirements are implemented timely as well as ensuring industry benchmarks related to quality and accuracy. Leads governance, task force and/or appropriate work groups responsible for establishing, updating, and sustaining enterprise-wide analysis, process improvement and sustainment of top-tier performance for Fairview and appropriate constituents as a primary contributor to strong financial health of the organization and a positive financial experience for its patients.

The System Director works in partnership with corporate departments including Legal, Compliance, Internal Audit, Information Technology and others to ensure timely and accurate responses and work is rendered.  Leads efforts to ensure systems, solutions, workflows, customers and staff are current and compliant with requirements.  Identifies and innovates solutions to optimize outcomes and performance.

The System Director serves as a subject matter expert / technical competence and accountable leader for enterprise standardization and optimization of domain leading in world-class performance in collaboration with team and partnerships. The role will lead in governance forums as well as act in designated liaison roles with partners and stakeholders to ensure comprehensive awareness, alignment, decision making, policy, metric transparency and performance that results in compliant and trusted outcomes for patients, providers, workforce and system.

Overall responsibilities include development and oversight of operational metrics, people, plans and programs including financial, systems/processes and internal controls for assigned Revenue Cycle functions in addition, this position ensures that the assigned Revenue Cycle functions actively engage in continuous process improvement to enhance performance and create efficiencies.

Leads continuous process improvement that supports exceptional patient/ family experience related to quality access, communication in the patient’s financial journey.  Focus on quality, consistency, simplified, convenient and personalized service that compliments the patient’s care. Understands, advocates (consumerism) and promotes transparency and informed decision-making in compliance with industry standards and on behalf of the patient /patient’s financial rights.

Ultimately responsible for compliance and quality standards for assigned Revenue Cycle functions.

Responsibilities

Provides strategic direction for coding, documentation, and clinical documentation integrity

  • Align direction with coding and documentation standards and regulatory requirements.
  • Ensure self, team, work products result in compliance with regulatory requirements and payer standards.
  • Coordinate and/or standardize people, processes, and technology across the Fairview system.
  • Ensures education is developed and activated including customer understanding, alignment with expectations.
  • Create service provider processes and culture to ensure subject matter expertise and support services to the organization.
  • Ensure policies and procedures meet regulatory requirements.
  • Coordinates quality assurance and completion of internal and external audits.  This includes the analysis of the audit results and associated action plans.
  • Understand current/future trends within healthcare finance, teach others and adjust operations as needed
  • Understand current/future trends within healthcare finance and adjust operations as needed.
  • Ensures industry-level workflows, decision criteria, algorithms are maintained including primary and secondary reviews are performed as appropriate while maximizing outcomes.
  • Implements and educates on reporting, analysis, and metrics to improve understanding of impact and outcomes.
  • Understands, tracks and implements process improvement to prevent denials includes coding and documentation support to overturn denials, as well as monitoring and trending, root cause identification and feedback to appropriate areas and staff.
  • Works closely with corporate, operations, quality and risk departments ensuring coding integrity and implementing improvement as appropriate for areas.
  • Demonstrates a leadership style that results in continuous improvement of processes, improved relationships with customers and with system goals.
  • Manage outside vendor relationships.
  • Prepares yearly departmental financial plans, monitors productivity and financial performance and maintains departmental operations within budget.
  • Manage the budget and ensure that resources meet the needs of the organization.

Responsible for human resources management and positive employee relations.

  • Implements and communicates to Human Resources.
  • Ensures selection of qualified employees for employment and implements staff development plans.
  • Ensures provision and documentation of ongoing training.
  • Establishes and maintains appropriate FTE levels.
  • Ensures compliance with human resources policies and related laws.
  • Values the uniqueness within and respects the differences between individuals.
  • Actively recruits and hires people to create a diverse and complementary team.
  • Models appreciation and acceptance of differences.
  • Provides a welcoming and supportive environment.
  • Creates and maintains a communication system to assure all employees have relevant, timely, and appropriate information.
  • Establishes and reviews expectations that guide, motivate, and hold people accountable for their work.
  • Provides feedback and coaching on an ongoing basis.
  • Conducts fair, accurate and timely performance reviews.
  • Discovers the aspirations and talents of employees and assists them in realizing their goals.
  • Knows what satisfies employees.
  • Continuously takes action to enhance employee satisfaction.
  • Improves overall employee engagement results.

Required Qualifications:

Education

  • BA/BS in Healthcare, Health Information Management or related field

Experience

  • 7 years healthcare experience at director-level equivalence

License/Certification/Registration

  • Registered Health Information Technician or Coding Certificate

Instructions for Resume Submission:

Please send your resume to Sophie at Sophie.Meyer@Fairview.org.