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Coding Manager

Coding manager is responsible for maintaining and overseeing efficient operation of the coding and charge entry processes in coding. The individual will support coding/charge entry functions, coordinate and support the activities of the coding specialists, and assist clients with coding/charge entry related processes and issues. Additionally, the position supports the company’s overall operations and client services by effectively and efficiently driving the Revenue Cycle Management process and delivering successful outcomes.

Responsibilities

• Responsible for supervising the coders and coordinating activities to ensure compliance with all third party and government regulations
• Responsible for coding across multiple databases and states
• Lead or participate providing feedback and suggestions as needed to represent coding and charge entry issues with internal and external teams
• Develop reports and presentations on projects for management
• Provide educational materials and trainings to providers and staff
• Develops procedures to increase departmental accuracy and efficiency through prompt identification and resolution of routine and complex coding problems
• Assesses, evaluates, and addresses daily workload and queues
• Analyzes productivity of medical coders
• Responsible for identifying trends and issues and communicating to upper management
• Responsible for monitoring activities including identifying areas of improvement and plan the implementation of improvement areas.
• Function as the initial resource to medical coders regarding all review process questions and/or concerns.
• Functions as provider’s liaison and contact/resource person for issues related to coding
• Effectively utilize ICD, CPT/HCPCS and related materials to investigate coding issues and produce accurate results
• Understand Medicare billing rules (i.e. LCD/NCD, CCI, Medical Necessity, and ABN) and communicate this information to staff, management, and physicians
• Serve as a resource to providers and clinical staff on coding questions and documentation requirements/guidelines
• Monitor services performed to ensure all encounters are captured coded and billed within appropriate timeframes
• Conduct billing audits to ensure the accuracy of the codes assigned
• Responsible for reconciling and cleaning up coding for month end
• Create competencies for coding staff
• Stay abreast of current changes in coding and reimbursement requirements for government programs and other third-party payers
• Actively participates in meetings and discussions to provide information to peers to enhance the knowledge and skills of the department
• Must adhere to all HIPAA guidelines/regulations
• Special projects and other duties as assigned

Qualifications

• Minimum of 5 years of previous coding and billing experience in revenue cycle
• Minimum of 2 years of supervisory/management experience required
• Associate’s or bachelor’s degree preferred
• Current coding certification and maintains certification
• Strong knowledge of medical terminology
• Ability to interpret, analyze and abstract data/documentation
• Must have specific knowledge of diagnostic and procedural terminology, ICD and CPT/HCPCS coding systems, and billing compliance rules
• Ability to work effectively in a cross-functional team-oriented setting
• Ability to educate/train others as needed
• Thorough understanding of regulatory compliance
• Exceptional computer skills and experience with Electronic Health Record
• Exceptional organizational, verbal, and written communication skills
• Strong ability to uphold organizational values, work with integrity and ethically, inspire the trust of others and treat people with respect
• Strong ability to use time efficiently and to prioritize/plan work activities
• Strong ability to follow instructions and management directions and complete assigned tasks on time and correctly
• Working knowledge of claims submissions (1500 and UB04 forms), and electronic coding software tools.