Carle Health
Overview
The Director of Coding/CDI/Education/Auditing is responsible for strategic oversight and operational leadership of coding, CDI, Auditing/Education functions across an eight-hospital integrated health system and all Carle physician groups. Oversees all aspects of inpatient, outpatient and professional coding operations, clinical documentation, coding audit and education, chargemaster coding activities including coding denial management. Plans, organizes, and leads the Health Information Management coding team ensuring compliance with federal, state and payer regulations and driving initiatives to improve coding quality and efficiency. The Director will collaborate with key stakeholders including clinical departments, revenue cycle teams, quality, compliance and leadership to optimize the coding process and to support both clinical and financial objectives for the organization. Reviews and manages offshore vendor and coding contracts. Serves as a resource for HIM topics to revenue cycle, medical and administrative committees as needed. Has budget responsibilities. Qualifications
Certifications: Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) Preferred: CCDS or CDIP Education Bachelor's Degree: Health Information Management or Health Information Administration Work Experience Health Information Management Director Level Leadership - 5 years Health Information Management - 7 years Knowledge And Skills Strong leadership and management skills, with ability to motivate team. Proven management and organizational skills. Knowledge of all major aspects of coding and audit and documentation integrity functions. Knowledge of hospital (facility) and physician (professional) coding and billing processes. Thorough understanding of codes sets, including ICD-10-CM/PCS, DRG, HCPCS, CPT, E/M, RVUs, LCDs and NCDs. Proven experience managing teams across multiple hospitals or large integrated system. Demonstrated success in driving quality improvement and revenue integrity initiatives. Excellent written and verbal communication skills. Analytical and critical thinking skills; ability to identify process improvement opportunities and implement solutions; ability to collaborate with all levels in the organization. Proficient in Microsoft Office products and EPIC, 3M Solventum, CDI, and CAC tools. Analytical knowledge in Tableau and Vizient encouraged. Responsibilities
Provide system wide leadership for facility and professional coding, CDI, and internal auditing programs. Leads the standardization and integration of processes across hospitals to ensure consistency and efficiency. Oversee accurate and timely coding and CDI concurrent reviews, physician query processes and education. Monitor offshore coding vendor quality and performance. Collaborate with clinicians, business partners and senior leadership, revenue cycle, compliance and quality departments to prioritize data-driven projects and provide quality information to support initiatives. Subject matter expert and advisor to senior leadership regarding regulatory changes, best practices and operational performance. Knowledge and application of regulatory requirements and payer specific coding guidelines and federal, state and payer reimbursement methods. Understand DRGs and severity systems as well as universal coding practices and guidelines. Oversee development, review and revision of department policies and procedures. Lead, mentor, and manage a team of managers, supervisors, auditors, CDI specialists, and coding professionals across all facilities. Monitor staff productivity and quality to ensure high performing teams meet or exceed KPIs. Foster a culture of accountability, compliance and professional development. Accountable for preparation and monitoring of operating and capital budgets and achieving budgetary success. Lead internal and external audits, including preparation, response and implementation of corrective actions. Oversee education and training of regulatory updates, coding guidelines and documentation standards. Identify trends, risks and opportunities for improvement. Provide leadership and collaborate with Executive Director and VP of HIM; establish vision, strategic direction and goals. Develop tactical plans to optimize coding accuracy, documentation quality and revenue cycle performance. Assure staff development through continuing education, career path development, and succession planning. Review and manage coding vendor contracts for HIM activities in coordination with senior leadership. Optimize technology platforms (e.g., EPIC, 3M) to enhance workflows and automate coding/CDI processes. Drive innovation through autonomous coding and AI integration. Lead system implementation projects and enhancements with HIM Technology and Revenue Cycle Systems. Analyze data to identify trends in coding quality, denial rates, query outcomes, physician compliance and financial performance; present regular reports with recommendations to executive leadership. Monitor workload and production goals; attend meetings as requested. CDI and auditing/training expert; ensure regular training and education of teams and providers according to policy. About Us
Find it here. Discover the job, the career, the purpose you were meant for. The supportive and inclusive team where you can thrive. The place where growth meets balance - and opportunities meet flexibility. Find it all at Carle Health. Based in Urbana, IL, Carle Health is a healthcare system with nearly 16,600 team members in eight hospitals, physician groups and a variety of healthcare businesses. Carle Health offers opportunities in several communities throughout central Illinois with potential for growth and life-long careers. Carle Health is an Equal Opportunity Employer; we do not discriminate based on race, color, sex, age, national origin, religion, sexual orientation, gender identity, veteran status, disability or any other protected class. We participate in E-Verify and may provide information from Form I-9 to confirm work authorization. Compensation And Benefits The compensation range for this position is $61.13 per hour - $105.14 per hour. This represents a good faith minimum and maximum range at the time of posting. Actual compensation offered will depend on factors including experience, qualifications, location, training, licenses, shifts worked and compensation model. Carle Health offers a comprehensive benefits package for team members and providers. To learn more visit careers.carlehealth.org/benefits.
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The Director of Coding/CDI/Education/Auditing is responsible for strategic oversight and operational leadership of coding, CDI, Auditing/Education functions across an eight-hospital integrated health system and all Carle physician groups. Oversees all aspects of inpatient, outpatient and professional coding operations, clinical documentation, coding audit and education, chargemaster coding activities including coding denial management. Plans, organizes, and leads the Health Information Management coding team ensuring compliance with federal, state and payer regulations and driving initiatives to improve coding quality and efficiency. The Director will collaborate with key stakeholders including clinical departments, revenue cycle teams, quality, compliance and leadership to optimize the coding process and to support both clinical and financial objectives for the organization. Reviews and manages offshore vendor and coding contracts. Serves as a resource for HIM topics to revenue cycle, medical and administrative committees as needed. Has budget responsibilities. Qualifications
Certifications: Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) Preferred: CCDS or CDIP Education Bachelor's Degree: Health Information Management or Health Information Administration Work Experience Health Information Management Director Level Leadership - 5 years Health Information Management - 7 years Knowledge And Skills Strong leadership and management skills, with ability to motivate team. Proven management and organizational skills. Knowledge of all major aspects of coding and audit and documentation integrity functions. Knowledge of hospital (facility) and physician (professional) coding and billing processes. Thorough understanding of codes sets, including ICD-10-CM/PCS, DRG, HCPCS, CPT, E/M, RVUs, LCDs and NCDs. Proven experience managing teams across multiple hospitals or large integrated system. Demonstrated success in driving quality improvement and revenue integrity initiatives. Excellent written and verbal communication skills. Analytical and critical thinking skills; ability to identify process improvement opportunities and implement solutions; ability to collaborate with all levels in the organization. Proficient in Microsoft Office products and EPIC, 3M Solventum, CDI, and CAC tools. Analytical knowledge in Tableau and Vizient encouraged. Responsibilities
Provide system wide leadership for facility and professional coding, CDI, and internal auditing programs. Leads the standardization and integration of processes across hospitals to ensure consistency and efficiency. Oversee accurate and timely coding and CDI concurrent reviews, physician query processes and education. Monitor offshore coding vendor quality and performance. Collaborate with clinicians, business partners and senior leadership, revenue cycle, compliance and quality departments to prioritize data-driven projects and provide quality information to support initiatives. Subject matter expert and advisor to senior leadership regarding regulatory changes, best practices and operational performance. Knowledge and application of regulatory requirements and payer specific coding guidelines and federal, state and payer reimbursement methods. Understand DRGs and severity systems as well as universal coding practices and guidelines. Oversee development, review and revision of department policies and procedures. Lead, mentor, and manage a team of managers, supervisors, auditors, CDI specialists, and coding professionals across all facilities. Monitor staff productivity and quality to ensure high performing teams meet or exceed KPIs. Foster a culture of accountability, compliance and professional development. Accountable for preparation and monitoring of operating and capital budgets and achieving budgetary success. Lead internal and external audits, including preparation, response and implementation of corrective actions. Oversee education and training of regulatory updates, coding guidelines and documentation standards. Identify trends, risks and opportunities for improvement. Provide leadership and collaborate with Executive Director and VP of HIM; establish vision, strategic direction and goals. Develop tactical plans to optimize coding accuracy, documentation quality and revenue cycle performance. Assure staff development through continuing education, career path development, and succession planning. Review and manage coding vendor contracts for HIM activities in coordination with senior leadership. Optimize technology platforms (e.g., EPIC, 3M) to enhance workflows and automate coding/CDI processes. Drive innovation through autonomous coding and AI integration. Lead system implementation projects and enhancements with HIM Technology and Revenue Cycle Systems. Analyze data to identify trends in coding quality, denial rates, query outcomes, physician compliance and financial performance; present regular reports with recommendations to executive leadership. Monitor workload and production goals; attend meetings as requested. CDI and auditing/training expert; ensure regular training and education of teams and providers according to policy. About Us
Find it here. Discover the job, the career, the purpose you were meant for. The supportive and inclusive team where you can thrive. The place where growth meets balance - and opportunities meet flexibility. Find it all at Carle Health. Based in Urbana, IL, Carle Health is a healthcare system with nearly 16,600 team members in eight hospitals, physician groups and a variety of healthcare businesses. Carle Health offers opportunities in several communities throughout central Illinois with potential for growth and life-long careers. Carle Health is an Equal Opportunity Employer; we do not discriminate based on race, color, sex, age, national origin, religion, sexual orientation, gender identity, veteran status, disability or any other protected class. We participate in E-Verify and may provide information from Form I-9 to confirm work authorization. Compensation And Benefits The compensation range for this position is $61.13 per hour - $105.14 per hour. This represents a good faith minimum and maximum range at the time of posting. Actual compensation offered will depend on factors including experience, qualifications, location, training, licenses, shifts worked and compensation model. Carle Health offers a comprehensive benefits package for team members and providers. To learn more visit careers.carlehealth.org/benefits.
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