Job Description

Overview:

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360 outpatient locations in 14 states providing more than 2.5 million patient visits annually. It is one of the nation's leading health systems with nearly 57,000 employees and physicians. Eighteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!


Responsibilities:

The Assistant Director of Coding is responsible at the enterprise level for coordinating and providing guidance on coding related issues with a view of bringing about process improvement and mitigating denials. He/She will review and analyze on a regular basis common coding issues denials and engage respective stakeholders across the enterprise on the needed steps to address such denials and or prevent them in the future. He/She will be responsible for designing medical necessity forms related to coding, following up on medical necessity edits and working with a cross-functional team to get these medical necessity edits addressed and or prevented. The Assistant Director of Coding works collaboratively with Regional Vice President of Clinical Integration, Respective Business Office Directors or Assignees, Directors of Coding, Health Information Management, and other relevant leadership team members in supplementing and assisting the department's functions pertaining to Coding. He/She will be the subject matter expert in the development and or maintenance of the tool(s) used in the tracking and or monitoring of medical necessity denials, coding issues and other related issues. He/She will perform other duties as assigned or required.
Qualifications:

EDUCATION, EXPERIENCE, TRAINING

Required qualifications:

1. Medical Graduate, licensed Physician Assistant or Nursing Graduate.
2. Certified Coding Specialist (CCS) certification
3. Thorough knowledge of ICD-10 codes, CPT codes, payment methodologies and denials processes
4. Excellent written, verbal communication and critical thinking skills
5. Prior use of an encoder software product for code assignment in an acute care setting
6. Basic computer experience required.

Preferred qualifications:

1. 5+ year of clinical experience in acute care setting.
2. Master's degree in related field
3. Minimum of three (3) years' experience with ICD-10 and CPT coding in an acute care setting
4. Prior experience in leadership role
5. Computer data entry with 10-key with accurate typing speed of 35 wpm


Pay Transparency:

Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. Benefits may vary based on employment status, i.e. full-time, part-time, per diem or temporary. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $100,006.40 to $164,736.00 on an annualized basis. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
Employment Status: Full Time Shift: Days Equal Employment Opportunity:

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf


Privacy Notice:
Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf