Director of Coding and Compliance (hybrid)

ChristianaCare, the largest healthcare system in Delaware is searching for a dynamic Director of Coding Compliance for our Medical Group Physician Optimization team. This highly experienced Director will report to the Vice President of Finance and build a team of up to 5 Coding Managers that they will supervise. They will also indirectly support Coders that will report to the Managers. This influential leader will support our providers through sustainable growth, and be committed to a strong revenue cycle foundation. This role will be responsible for the management, development and ongoing maintenance of our coding, compliance, and related training and education functions for the employed provider network. They will be accountable for sound fiscal and financial operations of assigned areas in the Medical Group and for ensuring compliance with the Christiana Care standards of excellence.

Delivering health, not just health care is our promise to our community. Be a part of an organization that makes a difference and impacts the lives of each other and the communities we serve through our commitment of being excellent today and even better tomorrow.

Key Responsibilities

• Oversees the planning, organizing, and execution of daily activities within the coding department within Medical Group.
• Establishes and maintains infrastructure to support ongoing provider education and audits related to coding and billing.
• Recruits, interviews, trains, and mentors the coding team.
• Sets performance standards and goals for direct reports and the Coding Department.
• Manages professional development and retention activities for the coding team.
• Provides strategic, financial, and operational coding guidance and leadership - inclusive of setting departmental goals and benchmarks for quality and efficiency.
• Develops coding policies and procedures to ensure standardization throughout the Medical Group
• Collaborates with hospital revenue cycle functions where appropriate to share best practices and increase standardization across the system.
• Acts as a senior liaison between providers, revenue cycle, quality, coding, other medical group leadership teams (e.g., provider compensation), and system stakeholders
• Leads professional fee coding operations and ensures coding goals and KPI's are achieved.
• Leverages best practice coding methodologies to deliver compliant and optimized coding that meets official coding guidelines.
• Provides updates on relevant coding guidelines to ensure compliance.
• Builds positive relationships with Providers to maintain open lines of communication and trust.
• Establishes an appropriate forum for distributing information and maintains controls to ensure information is shared timely and accurately.
• Develops and delivers appropriate provider and administrative training materials to improve billing and coding compliance and accuracy, in collaboration with members of the coding team
• Responds to inquiries with regards to CMS policies, third party payer guidelines, and billing department protocols and advises staff accordingly.
• Provides clarity and feedback on questions and educates physicians and staff related to coding and documentation requirements and compliance with regulatory guidelines.
• Identifies and addresses departmental concerns and establishes work plans to ensure long-term resolutions.

Position Qualifications

• Bachelor's degree in relevant field is required.
• Minimum of 5 years of Coding management experience, with an additional 3 years of direct physician coding experience required. Ten (10) years of equivalent combination of education and experience may be substituted in lieu of Bachelor's degree.
• Proficiency in multiple EMR's and the Microsoft Office suite.
• Excellent knowledge of payor and CMS coding guidelines.
• Educated in HIPAA regulations; must maintain strict confidentiality of patient Protected Health Information (PHI).
• Demonstrated ability to drive teams to consistently achieve quality and productivity standards.

Special Requirements

• Must be Certified Professional Coder (CPC) and/or CCS-P required.
• Must have knowledge of CPT-4 and ICD-10 codes.

Why ChristianaCare

• President/CEO Dr. Janice Nevin named among 50 Most Influential Clinical Executives in 2022 by Modern Healthcare
• ChristianaCare is the largest healthcare system in Delaware centered on improving health outcomes, making high-quality care more accessible and lowering health care costs.
• Achieved Healthgrades America's 50 Best Hospitals Award (2023) and rated by Forbes as the 2nd best health system for diversity and inclusion (2022)
• The region is rich with diverse cultures and offers some of the nation's best public and private schools, colleges, and universities.

About ChristianaCare

ChristianaCare, headquartered in Wilmington, DE employs over 13,000 caregivers with three acute care hospitals (1,336 beds), extensive network of primary care and outpatient specialty services, home health care, urgent care centers and free-standing emergency department. We have locations in Delaware, Maryland, New Jersey, and Pennsylvania. Our Christiana campus offers a Level I trauma center, Level III neonatal intensive care unit, comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care and women's health. ChristianaCare is ranked by Healthgrades as one of America's 50 Best Hospitals and continually ranked among the nation's best by U.S. News & World Report, Newsweek, and other national quality ratings. We're a nonprofit teaching health system with more than 260 residents and fellows.

Hybrid

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