Manager of Coding Resources

You’ll want to join Billings Clinic for our outstanding quality of care, exciting environment, interesting cases from a vast geography, advanced technology and educational opportunities. We are in the top 1% of hospitals internationally for receiving Magnet® Recognition consecutively since 2006.

And you’ll want to stay at Billings Clinic for the amazing teamwork, caring atmosphere, and a culture that values kindness, safety and courage. This is an incredible place to learn and grow. Billings, Montana, is a friendly, college community in the Rocky Mountains with great schools and abundant family activities. Amazing outdoor recreation is just minutes from home. Four seasons of sunshine!

You can make a difference here.

About Us
Billings Clinic is a community-owned, not-for-profit, Physician-led health system based in Billings with more than 4,700 employees, including over 550 physicians and non-physician providers. Our integrated organization consists of a multi-specialty group practice and a 304-bed hospital. Learn more about Billings Clinic (our organization, history, mission, leadership and regional locations) and how we are recognized nationally for our exceptional quality.

Your Benefits
We provide a comprehensive and competitive benefits package to all full- and part-time employees (minimum of 20 hours/week), including Medical, Dental, Vision, 403(b) Retirement Plan with employer matching, Defined Contribution Pension Plan, Paid Time Off, employee wellness program, and much more.

Magnet: Commitment to Nursing Excellence
Billings Clinic is proud to be recognized for nursing excellence as a Magnet®-designated organization, joining only 97 other organizations worldwide that have achieved this honor four times. The re-designation process happens every four years.

Pre-Employment Requirements
All new employees must complete several pre-employment requirements prior to starting.

Manager of Coding Resources
FINANCE (BILLINGS CLINIC CLINIC)
req11327

Shift: Day
Employment Status: Full-Time (.75 or greater)
Hours per Pay Period: 1.00 = 80 hours every two weeks (Exempt)
Starting Wage DOE

The Coding Resources Manager will serve as the focal point for coding and coding compliance related activities. Responsible for the development, implementation and management of the coding compliance programs for all areas of the organization (i.e., nursing home, patient accounts billing functions, acute care hospital, and physician clinic). Position will be responsible for establishing and assessing coding and compliance standards in conjunction with organizational policies/procedures, regulatory requirements and state and federal requirements/standards. Prepares and communicates findings, conclusions and recommendations, collaborates with all levels of the leadership team to address deficiencies and provide education as needed. Accountabilities include quality of services; short and long-range planning to achieve goals; fiscal control; physician and departmental relations; personnel management; compliance as related to coding and billing functions; coding of professional and facilities services.

Essential Job Functions

• Interprets supports and models behaviors consistent with the mission and philosophy of Billings Clinic and department/service.
• Develops, implements, monitors and revises coding compliance requirements as it relates to all areas of the organization to include requirements for nursing home, patient accounts billing functions, acute care hospital, and physician clinic. Responsibilities include review of all government and third party bulletins to evaluate changes and to coordinate and communicate with the impacted areas to ensure changes are made to comply with the new requirements. Coordinates closely with all levels of the leadership team.
• Develops and implements audit criteria to measure coding compliance with policies, procedures and governmental/payer regulations and to detect any potential violations. Develops an audit schedule and work plan. Ensures that the audit schedule is maintained and that recommendations and deficiencies identified in the audit are implemented and resolved. In coordination with legal counsel, reports self-discovered violations of program requirements.
• Develops and maintains policies and procedures that promote Billings Clinic’s commitment to coding/billing compliance and to address high-risk areas. Develops, implements and maintains written facility-specific coding guidelines for both hospital and clinic coding which address specific coding issues and meet regulated coding practices.
• Develops and implements reporting and tracking systems to document coding compliance efforts and progress made in establishing methods and/or processes to improve the efficiency and quality of services and/or to prevent or reduce the organization’s vulnerability to illegal, unethical or improper conduct, fraud, abuse and waste. Develops and maintains all Medical Records coding compliance related files, reports and databases.
• Monitors education and training for all coding staff to ensure staff understand and comply with pertinent federal, state and regulatory requirements and standards for coding and compliance.
• Participates as part of the corporate compliance leadership team. Provides direction and advice for medical staff and other employees for coding and/or compliance related matters. Participates in Institutional and Reimbursement Compliance Committees as active member. Reports coding and/or compliance activities to these Committees as appropriate.
• Prepares and develops annual budget for Coding Resources coding and compliance related expenses; maintains budget variances within acceptable standards. Develops and makes recommendations for both short and long term planning for coding and compliance related matters.
• Maintains standards for AR and coding turnaround to support timely billing and financial responsibility. Assures accuracy and quality through regular quality review of all coding staff.
• Monitors and evaluates Case Mix Index. Directs activities of Nurse Reimbursement Specialist to achieve optimum reimbursement based upon documentation. In coordination with Nurse Reimbursement Specialist works with Medical Staff to achieve accurate documentation for services provided, guidelines for coding complications, and education programs related to coding and documentation requirements.
• Identifies needs and sets goals for own growth and development; meets all mandatory organizational and departmental requirements.
• Maintains competency in all organizational, departmental and outside agency environmental, employee or patient safety standards relevant to job performance.
• Performs other duties as assigned or needed to meet the needs of the department/organization.

Minimum Qualifications

Or an equivalent combination of education and experience relating to the above tasks, knowledge, skills and abilities will be considered. Employees that require a licensed or certification must be properly licensed/certified and the licensure/certification must be in good standing.

Billings Clinic is Montana’s largest health system serving Montana, Wyoming and the western Dakotas. A not-for-profit organization led by a physician CEO, the health system is governed by a board of community members, nurses and physicians. Billings Clinic includes an integrated multi-specialty group practice, tertiary care hospital and trauma center, based in Billings, Montana. Learn more at www.billingsclinic.com/aboutus

Billings Clinic is committed to being an inclusive and welcoming employer, that strives to be kind, safe, and courageous in all we do. As an equal opportunity employer, our policies and processes are designed to achieve fair and equitable treatment of all employees and job applicants. All employees and job applicants will be provided the same treatment in all aspects of the employment relationship, regardless of race, color, religion, sex, gender identity, sexual orientation, pregnancy, marital status, national origin, age, genetic information, military status, and/or disability. To ensure we provide an accessible candidate experience for prospective employees, please let us know if you need any accommodations during the recruitment process.