Patient Access Coord I

Screen reader users may encounter difficulty with this site. For assistance with applying, please contact [email protected] . If you have questions while submitting an application, please review these frequently asked questions .

Current Employees and Students:
If you are currently employed or enrolled as a student at The Ohio State University, please log in to Workday to use the internal application process.

Welcome to The Ohio State University's career site.  We invite you to apply to positions of interest. In order to ensure your application is complete, you must complete the following:

• Ensure you have all necessary documents available when starting the application process. You can review the additional job description section on postings for documents that may be required.
• Prior to submitting your application, please review and update (if necessary) the information in your candidate profile as it will transfer to your application. 

Job Title:
Director, Coding and Compliance

Department:
Health System Shared Services | Revenue Management

Scope of Position

The Director of Coding, Compliance and Clinical Documentation Enhancement is responsible for assuring high quality information collection and reporting systems for medical information management services, including coding, data quality management, and compliance. The information collected and used by medical information management staff is interconnected with the clinical and business systems of the health system and is used for patient care, teaching, research, hospital operations, quality assurance, and reimbursement. Accurate coding and compliance is essential for a financially viable health care organization.

The Director is responsible for managing department staff, programs, policies and activities related to coding services, data quality management, clinical documentation enhancement and Medical Information Management compliance for the health system.  Specific areas include University Hospital (including the Ross Heart Hospital, Dodd Hall, ambulatory care provided in McCampbell Hall, Morehouse Medical Plaza and the Eye and Ear Institute), The James (inpatient, OBS, SDS), OSU Harding, and University Hospital East. Assists in planning, organizing and controlling medical record coding services, coding quality and billing accuracy (as related to coding services), and compliance to meet the patient care, teaching, research and administrative needs of The Ohio State University Wexner Medical Center.  Effective management of coding and documentation enhancement staff resources is required to support accurate, timely and complete coding information required in the billing cycle.

The Director analyzes performance to assess quality of coding and medical record documentation and prepares recommendations for action based on the results. Monitors effectiveness of data quality program and recommends improvements as necessary. Works with Administrative Director, Coding Data Analyst and Assistant Director of Documentation Improvement to monitor the various business units’ Case Mix Index (CMI) to identify opportunities for improvement in coding. Responds to reports from Coding Data Analyst that identify potential coding errors or inconsistencies.  The Director oversees the department’s compliance plan. This includes assuring the plan addresses all aspects of medical information management compliance, including assessment, training, policies and procedures, monitoring and corrective action.

In the absence of the Administrative Director, the Director provides direction, supervision, and support to all Medical Information Management areas and staff. Advises administration, medical and managerial staff regarding specific issues and problems. Provides assistance as needed. Resolves intra-departmental and inter-departmental problems related to coding, documentation and compliance.

Position Summary  

This position provides administrative direction to the coding services program and clinical documentation enhancement in Medical Information Management. Manages the program for high quality, timely coding of diagnoses and procedures for inpatient and outpatient accounts, using ICD-9-CM, ICD-10-CM/PCS and CPT-4 coding classification systems, to meet the hospitals’ billing system requirements. Manages the abstracting of data elements required for billing (admission type and source, discharge disposition, attending physician).  Monitors the results of the program for quality improvement and timeliness. Manages ongoing review of coding for accuracy. Coding accuracy is critical to the Medical Center’s Integrity Program and accurate reimbursement.

This position provides administrative direction to the compliance program in Medical Information Management. The Director manages the compliance program, with emphasis on patient confidentiality and accurate coding and abstracting of data elements required for billing (admission type and source, discharge disposition, attending physician). This staff member assures compliance with CMS regulations regarding coding and data abstraction in order to reduce the organization’s financial risk if non-compliant. The Director works with the Coding Data Analyst to benchmark the results of these programs against peer organizations for quality improvement and timeliness. Provides education on coding, compliance and documentation requirements. Directs the coding continuing education program for the department’s coding, documentation enhancement and data quality management staff.  Maintains department compliance plan and monitors performance against plan. Provides support for administrative and research needs of the organization by retrieving abstracted and other patient and or physician specific information from the abstracting system, data marts and information warehouse in response to requests from authorized requestors. The Director has strong organizational relationships with Case Management, Access and Revenue Management, Business Planning and the Information Warehouse; this staff member advises on issues related to coding and documentation as related to utilization management, financial performance, strategic planning, and administrative information needs. Position may assume departmental responsibility in absence of Administrative Director.

Duties and Responsibilities  

60% Management of Coding, and Data Quality Programs

• Plans, organizes, directs and coordinates all administrative and operational coding, data quality and compliance activities for the University Health System.
• Assists in development, implementation and assessment of long and short range goals and objectives and major plans and programs; assures goals and objectives are integrated with  the Key Result Areas (KRAs) of the Health System. 
• Assists in development, administration, interpretation, and assessment of coding, data quality, and compliance policies and procedures.
• Participates as an active member of committees and task forces charged with issues related to accurate coding, documentation, and financial reimbursement. 
• Coordinates annual external coding audit to ensure coding compliance.
• Provides oversight on MS-DRG and APR-DRG appeals process in response to Recovery Audit Contractor (RAC), Medicare Administrative Contractors (MACs) and Medicaid denials.
• Analyzes MS-DRG, APR-DRG, and NCCI and OCE billing edits and issues/denials and reports results the Administrative Director, Revenue Management, and Corporate Compliance.
• Serves as project director for implementation of ICD-10-CM and ICD-10-PCS.
• Assists in planning, developing and controlling budgets (personnel, capital equipment, and operational) and allocating manpower and fiscal resources for areas of responsibility and for achievement of goals and objectives.
• Controls expenditures, monitors fiscal performance.
• Analyzes expenditures; assesses current and future needs and plans for programs, personnel etc.
• Assesses and recommends organizational program and staffing changes.
• Participates in planning new facilities and programs; assists in forecasting needs and preparing budgets for personnel, equipment and space.
• Provides for and evaluates impact of innovations and changes in programs, policies, and procedures.
• Assists Medical Staff, Administrators, Directors and Hospital staff by providing accurate and timely collection and retrieval of information.

• Prepares administrative and clinical statistical reports as requested. Assists in preparation of weekly, monthly and annual reports.
• Establishes work measurement and quality control standards and guidelines for University Health System coding, data quality and documentation enhancement; monitors area’s performance relative to JC(Joint Commission), CMS (Center for Medicare and Medicaid Services) and third party payer standards.
• Establishes staffing patterns and allocates manpower resources to assure adequate coverage of responsible areas.
• Evaluates workload and distributes responsibility accordingly.
• Interprets departmental, Hospital and University policies as they relate to Departmental personnel and operations.
• Interviews, selects, trains, coaches and appraises personnel in areas of responsibility.
• Counsels and evaluates employees and resolves complaints and conflicts; initiates disciplinary action.
• Coordinates the group meetings for areas of responsibility, including agendas, minutes, and presentations.
• Directs the coding continuing education program for the department’s coding, documentation enhancement and data quality management staff.  Consults with Assistant Director of Documentation Enhancement and the Assistant Director, James Outpatient, Medical Information Management regarding coding, and data quality issues.
• Implement and utilize computer assisted coding for optimal coding productivity and quality.

25% Management of Compliance Program

• Develops, and monitors health information management compliance program to assure compliance with regulations and standards (i.e. HIPAA, state and federal law, Joint Commission, CARF, CMS Medicare Conditions of Participation).
• Plans and convenes quarterly compliance meeting of the Department of Medical Information Management.
• Works with Coding Data Analyst to analyze coding performance.
• Prepares quarterly reports on compliance activities to Corporate Compliance Activity as requested.
• Monitors closely MS-DRGs and APR-DRG’s targeted by OIG.
• Monitors performance of PEPPER report and reports results to Revenue Executive Committee, Quality and Operations, Corporate Compliance and other interested parties.
• Collects information, analyzes performance in areas of emphasis of the compliance program; updates compliance plan as needed.
• Provides training to physicians, other health care providers, physician office staff and HIM staff on documentation and coding compliance.
• Prepares presentations on Case Mix Index (CMI), coding and documentation performance, and changes in the regulatory environment to various leadership groups.
• Maintains departmental records and files.
• Observes provisions of Medical Staff By-laws, Rules and Regulations relating specifically to Medical Information Management.
• Assures adherence to Quality Improvement Organizations (QIO) and Medicare and Medicaid regulations on medical record documentation.
• Assures institutional conformance with or recommendations concerning legal, ethical, accreditation, licensure, certification, University-related or other administrative requirements regarding collection, processing, storage and control of medical information.
• Advises Administrative Director concerning compliance issues in Medical Information Management; recommends appropriate action.
• Provides annual compliance training to Medical Information Management staff.

15% of time – As Assigned

• Assists in coordinating daily activities between Medical Information Management, clinical staff, medical staff administration, patient financial services and department directors.  Requires use of extreme tact and diplomacy to facilitate timely documentation completion.
• In absence of Administrative Director or as assigned, participates in and attends meetings of the Medical Documentation Steering Committee, Revenue Cycle Committee, Compliance Committee, and other hospital and Medical Staff Committees.
• Assists Administrative Director in planning for student clinical experiences. Actively participates in the clinical practice and classroom preparation of students by teaching courses, guest lecturing, special project participation and collaborative research efforts.
• Facilities communications and resolution of operating problems.

• Provides advice and consultation to administration, management, medical staff and others in regard to programs, policies and procedures, and systems which impact Medical Information Management.
• Represents Department and/or Administrative Director, as assigned, in contacts with legal representatives, insurance company auditors/representatives, Quality Improvement Organization representatives, government officials and licensing agencies.
• Serves as liaison with external coding audit firm, schedules audits, reviews preliminary findings, works with managers to develop action plans to address recommendations, monitors and follows-up.
• Serves as a resource person and assures adherence to regulations regarding collection, storage, completion and retrieval of coded medical information.

• Provides direction, supervision, and support to all Medical Information Management areas and staff.  Serves as senior department manager in absence of Director.
• Resolves intra and inter departmental operating problems.
• Coordinates operations and services.
• Advises Administration, Medical and managerial staff regarding specific issues and problems; provides assistance as needed.

Organizational Expectations  

Practices within the Medical Center's policies and procedures.  Adheres to the Medical Center Values of Excellence, Collaborating as One University, Integrity and Personal Accountability, Openness and Trust, Diversity in People and Ideas, Change and Innovation, Simplicity in Our Work, Empathy and Compassion, and Leadership.

Additional Information:

Location:
Ackerman Rd, 660 (0242)

Position Type:
Regular

Scheduled Hours:
40

Shift:
First Shift

Salary Grade:
Health System Annual 030

Final candidates are subject to successful completion of a background check.  A drug screen or physical may be required during the post offer process.

Thank you for your interest in positions at The Ohio State University and Wexner Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the Candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status. For answers to additional questions please review the frequently asked questions .

The Ohio State University is an equal opportunity employer.

All qualified applicants will receive consideration for employment without regard to age, ancestry, color, disability, ethnicity, gender identity or expression, genetic information, HIV/AIDS status, military status, national origin, race, religion, sex, gender, sexual orientation, pregnancy, protected veteran status, or any other bases under the law.

Applicants are encouraged to complete and submit the Equal Employment Identification form.

Screen reader users may encounter difficulty with this site. For assistance with applying, please contact [email protected] . If you have questions while submitting an application, please review these frequently asked questions .

Current Employees and Students:
If you are currently employed or enrolled as a student at The Ohio State University, please log in to Workday to use the internal application process.

Welcome to The Ohio State University's career site.  We invite you to apply to positions of interest. In order to ensure your application is complete, you must complete the following:

• Ensure you have all necessary documents available when starting the application process. You can review the additional job description section on postings for documents that may be required.
• Prior to submitting your application, please review and update (if necessary) the information in your candidate profile as it will transfer to your application. 

Job Title:
Director, Coding and Compliance

Department:
Health System Shared Services | Revenue Management

Scope of Position

The Director of Coding, Compliance and Clinical Documentation Enhancement is responsible for assuring high quality information collection and reporting systems for medical information management services, including coding, data quality management, and compliance. The information collected and used by medical information management staff is interconnected with the clinical and business systems of the health system and is used for patient care, teaching, research, hospital operations, quality assurance, and reimbursement. Accurate coding and compliance is essential for a financially viable health care organization.

The Director is responsible for managing department staff, programs, policies and activities related to coding services, data quality management, clinical documentation enhancement and Medical Information Management compliance for the health system.  Specific areas include University Hospital (including the Ross Heart Hospital, Dodd Hall, ambulatory care provided in McCampbell Hall, Morehouse Medical Plaza and the Eye and Ear Institute), The James (inpatient, OBS, SDS), OSU Harding, and University Hospital East. Assists in planning, organizing and controlling medical record coding services, coding quality and billing accuracy (as related to coding services), and compliance to meet the patient care, teaching, research and administrative needs of The Ohio State University Wexner Medical Center.  Effective management of coding and documentation enhancement staff resources is required to support accurate, timely and complete coding information required in the billing cycle.

The Director analyzes performance to assess quality of coding and medical record documentation and prepares recommendations for action based on the results. Monitors effectiveness of data quality program and recommends improvements as necessary. Works with Administrative Director, Coding Data Analyst and Assistant Director of Documentation Improvement to monitor the various business units’ Case Mix Index (CMI) to identify opportunities for improvement in coding. Responds to reports from Coding Data Analyst that identify potential coding errors or inconsistencies.  The Director oversees the department’s compliance plan. This includes assuring the plan addresses all aspects of medical information management compliance, including assessment, training, policies and procedures, monitoring and corrective action.

In the absence of the Administrative Director, the Director provides direction, supervision, and support to all Medical Information Management areas and staff. Advises administration, medical and managerial staff regarding specific issues and problems. Provides assistance as needed. Resolves intra-departmental and inter-departmental problems related to coding, documentation and compliance.

Position Summary  

This position provides administrative direction to the coding services program and clinical documentation enhancement in Medical Information Management. Manages the program for high quality, timely coding of diagnoses and procedures for inpatient and outpatient accounts, using ICD-9-CM, ICD-10-CM/PCS and CPT-4 coding classification systems, to meet the hospitals’ billing system requirements. Manages the abstracting of data elements required for billing (admission type and source, discharge disposition, attending physician).  Monitors the results of the program for quality improvement and timeliness. Manages ongoing review of coding for accuracy. Coding accuracy is critical to the Medical Center’s Integrity Program and accurate reimbursement.

This position provides administrative direction to the compliance program in Medical Information Management. The Director manages the compliance program, with emphasis on patient confidentiality and accurate coding and abstracting of data elements required for billing (admission type and source, discharge disposition, attending physician). This staff member assures compliance with CMS regulations regarding coding and data abstraction in order to reduce the organization’s financial risk if non-compliant. The Director works with the Coding Data Analyst to benchmark the results of these programs against peer organizations for quality improvement and timeliness. Provides education on coding, compliance and documentation requirements. Directs the coding continuing education program for the department’s coding, documentation enhancement and data quality management staff.  Maintains department compliance plan and monitors performance against plan. Provides support for administrative and research needs of the organization by retrieving abstracted and other patient and or physician specific information from the abstracting system, data marts and information warehouse in response to requests from authorized requestors. The Director has strong organizational relationships with Case Management, Access and Revenue Management, Business Planning and the Information Warehouse; this staff member advises on issues related to coding and documentation as related to utilization management, financial performance, strategic planning, and administrative information needs. Position may assume departmental responsibility in absence of Administrative Director.

Duties and Responsibilities  

60% Management of Coding, and Data Quality Programs

• Plans, organizes, directs and coordinates all administrative and operational coding, data quality and compliance activities for the University Health System.
• Assists in development, implementation and assessment of long and short range goals and objectives and major plans and programs; assures goals and objectives are integrated with  the Key Result Areas (KRAs) of the Health System. 
• Assists in development, administration, interpretation, and assessment of coding, data quality, and compliance policies and procedures.
• Participates as an active member of committees and task forces charged with issues related to accurate coding, documentation, and financial reimbursement. 
• Coordinates annual external coding audit to ensure coding compliance.
• Provides oversight on MS-DRG and APR-DRG appeals process in response to Recovery Audit Contractor (RAC), Medicare Administrative Contractors (MACs) and Medicaid denials.
• Analyzes MS-DRG, APR-DRG, and NCCI and OCE billing edits and issues/denials and reports results the Administrative Director, Revenue Management, and Corporate Compliance.
• Serves as project director for implementation of ICD-10-CM and ICD-10-PCS.
• Assists in planning, developing and controlling budgets (personnel, capital equipment, and operational) and allocating manpower and fiscal resources for areas of responsibility and for achievement of goals and objectives.
• Controls expenditures, monitors fiscal performance.
• Analyzes expenditures; assesses current and future needs and plans for programs, personnel etc.
• Assesses and recommends organizational program and staffing changes.
• Participates in planning new facilities and programs; assists in forecasting needs and preparing budgets for personnel, equipment and space.
• Provides for and evaluates impact of innovations and changes in programs, policies, and procedures.
• Assists Medical Staff, Administrators, Directors and Hospital staff by providing accurate and timely collection and retrieval of information.

• Prepares administrative and clinical statistical reports as requested. Assists in preparation of weekly, monthly and annual reports.
• Establishes work measurement and quality control standards and guidelines for University Health System coding, data quality and documentation enhancement; monitors area’s performance relative to JC(Joint Commission), CMS (Center for Medicare and Medicaid Services) and third party payer standards.
• Establishes staffing patterns and allocates manpower resources to assure adequate coverage of responsible areas.
• Evaluates workload and distributes responsibility accordingly.
• Interprets departmental, Hospital and University policies as they relate to Departmental personnel and operations.
• Interviews, selects, trains, coaches and appraises personnel in areas of responsibility.
• Counsels and evaluates employees and resolves complaints and conflicts; initiates disciplinary action.
• Coordinates the group meetings for areas of responsibility, including agendas, minutes, and presentations.
• Directs the coding continuing education program for the department’s coding, documentation enhancement and data quality management staff.  Consults with Assistant Director of Documentation Enhancement and the Assistant Director, James Outpatient, Medical Information Management regarding coding, and data quality issues.
• Implement and utilize computer assisted coding for optimal coding productivity and quality.

25% Management of Compliance Program

• Develops, and monitors health information management compliance program to assure compliance with regulations and standards (i.e. HIPAA, state and federal law, Joint Commission, CARF, CMS Medicare Conditions of Participation).
• Plans and convenes quarterly compliance meeting of the Department of Medical Information Management.
• Works with Coding Data Analyst to analyze coding performance.
• Prepares quarterly reports on compliance activities to Corporate Compliance Activity as requested.
• Monitors closely MS-DRGs and APR-DRG’s targeted by OIG.
• Monitors performance of PEPPER report and reports results to Revenue Executive Committee, Quality and Operations, Corporate Compliance and other interested parties.
• Collects information, analyzes performance in areas of emphasis of the compliance program; updates compliance plan as needed.
• Provides training to physicians, other health care providers, physician office staff and HIM staff on documentation and coding compliance.
• Prepares presentations on Case Mix Index (CMI), coding and documentation performance, and changes in the regulatory environment to various leadership groups.
• Maintains departmental records and files.
• Observes provisions of Medical Staff By-laws, Rules and Regulations relating specifically to Medical Information Management.
• Assures adherence to Quality Improvement Organizations (QIO) and Medicare and Medicaid regulations on medical record documentation.
• Assures institutional conformance with or recommendations concerning legal, ethical, accreditation, licensure, certification, University-related or other administrative requirements regarding collection, processing, storage and control of medical information.
• Advises Administrative Director concerning compliance issues in Medical Information Management; recommends appropriate action.
• Provides annual compliance training to Medical Information Management staff.

15% of time – As Assigned

• Assists in coordinating daily activities between Medical Information Management, clinical staff, medical staff administration, patient financial services and department directors.  Requires use of extreme tact and diplomacy to facilitate timely documentation completion.
• In absence of Administrative Director or as assigned, participates in and attends meetings of the Medical Documentation Steering Committee, Revenue Cycle Committee, Compliance Committee, and other hospital and Medical Staff Committees.
• Assists Administrative Director in planning for student clinical experiences. Actively participates in the clinical practice and classroom preparation of students by teaching courses, guest lecturing, special project participation and collaborative research efforts.
• Facilities communications and resolution of operating problems.

• Provides advice and consultation to administration, management, medical staff and others in regard to programs, policies and procedures, and systems which impact Medical Information Management.
• Represents Department and/or Administrative Director, as assigned, in contacts with legal representatives, insurance company auditors/representatives, Quality Improvement Organization representatives, government officials and licensing agencies.
• Serves as liaison with external coding audit firm, schedules audits, reviews preliminary findings, works with managers to develop action plans to address recommendations, monitors and follows-up.
• Serves as a resource person and assures adherence to regulations regarding collection, storage, completion and retrieval of coded medical information.

• Provides direction, supervision, and support to all Medical Information Management areas and staff.  Serves as senior department manager in absence of Director.
• Resolves intra and inter departmental operating problems.
• Coordinates operations and services.
• Advises Administration, Medical and managerial staff regarding specific issues and problems; provides assistance as needed.

Organizational Expectations  

Practices within the Medical Center's policies and procedures.  Adheres to the Medical Center Values of Excellence, Collaborating as One University, Integrity and Personal Accountability, Openness and Trust, Diversity in People and Ideas, Change and Innovation, Simplicity in Our Work, Empathy and Compassion, and Leadership.

Additional Information:

Location:
Ackerman Rd, 660 (0242)

Position Type:
Regular

Scheduled Hours:
40

Shift:
First Shift

Salary Grade:
Health System Annual 030

Final candidates are subject to successful completion of a background check.  A drug screen or physical may be required during the post offer process.

Thank you for your interest in positions at The Ohio State University and Wexner Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the Candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status. For answers to additional questions please review the frequently asked questions .

The Ohio State University is an equal opportunity employer.

All qualified applicants will receive consideration for employment without regard to age, ancestry, color, disability, ethnicity, gender identity or expression, genetic information, HIV/AIDS status, military status, national origin, race, religion, sex, gender, sexual orientation, pregnancy, protected veteran status, or any other bases under the law.

Applicants are encouraged to complete and submit the Equal Employment Identification form.