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Coding Manager

Location Charlestown, United States
Posted 28-October-2021
Description
GENERAL SUMMARY/OVERVIEW STATEMENT:

The Coding Manager reports to the Professional Billing Office Associate Director of Coding & QA Services and is responsible for directing coding unit activities to ensure correct coding of professional services in a timely manner.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

The Coding Manager is required to:

* Coordinate efforts of coding coordinators and staff to meet unit objectives. Expected to be on site and available 80% of the time including whenever coding coordinators are scheduled to be off site. Expected to be onsite and available during critical business needs (eg fiscal year end, close of month, etc.).
* Direct and monitor coding coordinator activities to ensure effective coding procedures are in place to enable the unit to be in compliance with third party payor requirements and to ensure revenue is optimized.
* Develop and maintain coding unit procedures. Conduct annual review of all procedures and revise accordingly in response to indicators of poor performance or policy changes. Coding unit procedures encompass coding process flows, human resource procedures, and general unit procedures.
* Identify key performance indicators, define parameters of success and develop action plan for indicators of poor performance. Monitor key indicators on a daily basis and adjust operations accordingly to meet unit objectives. Create and maintain reports of key operational measures. Communicate measures and response to indicators of poor performance to the senior management team at established intervals and on an ad hoc basis. Authorized to reprioritize staff to meet daily production requirements.
* In conjunction with the quality assurance unit, responsible for the overall quality of the coding product. Revise procedures in response to indicators of poor quality to ensure compliance with third party payor and governmental requirements.
* Understand and implement use of key coding tools (TES/Ingenix) to improve the quality of the coding product. Working with the quality assurance unit, communicate, monitor and maintain coding edits based third party payor regulations.
* Coordinate recruiting and hiring efforts for new unit staff. Complete annual performance reviews for coding specialists and coordinator staff. Provide regular feedback to staff to ensure their success. Notify senior management team of ongoing non-performance issues. Maintain unit personnel records.
* Act as technical expert coding resource to coding staff and the unit's customers. Participate in coding research initiatives as requested. Maintain competency in professional fee coding and compliance including CPT, ICD-9, modifier, compliance and third party payor guidelines.
* Complete special projects as assigned by the senior management team which require defining problems, determining work sequences, summarizing findings, and implementing required changes.
* Maintain certification in physician coding (CPC preferred).

QUALIFICATIONS:

* Bachelor's degree in medical, business or related field with five years of experience in a medical or related field; or
* Two years of college including at least twelve semester hours in medical or related field and six to eight years progressively responsible experience as described above.
* Coding certification or willingness to obtain certification within two years of assuming position.
* Working knowledge of MS Word, MS Excel, MS Access, and MS PowerPoint applications.

SKILLS/ABILITIES/COMPETENCIES REQUIRED

This position requires demonstrated leadership qualities. A working knowledge of ICD-9 and CPT-4 coding for professional fee services is required. Course work in business, anatomy and physiology, medical terminology and insurance reimbursement policies and regulations is preferred. Good written and verbal communication skills and the ability to prioritize and organize work to meet strict deadlines is required.

WORKING CONDITIONS:

The Professional Billing Office is located in the Charlestown Navy Yard campus.

SUPERVISORY RESPONSIBILITY

Responsible for direct supervision of FTEs comprised of coding specialist and coding specialist assistant staff.

FISCAL RESPONSIBILITY:

Responsible for controlling expenditures of the coding unit to ensure that budget is not exceeded.

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