Risk Adjustment Coding Manager Jobs in Georgia (NOW HIRING)

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Work Shift
Day
Work Day(s)
Monday-Friday
Shift Start Time
8:00 AM
Shift End Time
5:00 PM
Worker Sub-Type
Regular
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Job Description
Works in partnership with Coding/HIM department leaders to provide coding program direction and management for service lines within Children's Healthcare of Atlanta. Develops and oversees functional area and system programs. Works closely with internal and external stakeholders, which include patients and families, vendors, payers, coding staff, clinical operations and physicians in partnership with the Children's Coding/HIM teams and overall revenue cycle team.
Experience

• 1 year of experience developing and coordinating small or department programs
• 1 year of experience in a professional working environment
• 3 years of experience in coding in a hospital or physician practice/clinic setting

• Master's degree
• Registered Health Information Technologist (RHIT) or Registered Health Information Administrator (RHIA) certification from the American Health Information Management Association
• Vendor management experience
• Experience optimizing Epic revenue cycle applications
• Demonstrated experience developing and interpreting revenue cycle data using Epic, SQL reporting, Microsoft Access, QlikView data visualization or similar technologies

• Bachelor's degree in business administration, accounting, finance, or related area

• Certified Coding Specialist (CCS) from the American Health Information Management Association
• Certified Coding Specialist - Physician (CCS-P) from the American Health Information Management Association
• Certified Professional Coder (CPC) from the American Academy of Professional Coders (AAPC)

• Demonstrated ability to develop and manage budgets and other financial skills
• Strong communication, facilitation, and presentation skills
• Strong interpersonal skills, including demonstrated experience working collaboratively with teams and employees at all levels within an organization
• Must possess excellent customer service skills
• Must have strong analytical and critical thinking skills to support problem solving and associated change management
• Demonstrated success in program development, project planning, and project management
• Ability to multitask, balance multiple priorities, and work independently and within teams
• Personal organization and time management
• Demonstrated knowledge of the conventions, rules, and guidelines for multiple classification systems, including ICD-10 diagnosis and procedures, CPT and evaluation & management coding systems
• Knowledge of multiple reimbursement systems (e.g., Medicare Severity-Diagnosis Related Groups (MS-DRG) and Ambulatory Payment Classification (APC)
• Knowledge of clinical documentation improvement concepts
• Ability to accurately interpret and implement regulatory standards, including the National Correct Coding Initiative (NCCI) and Medically Unlikely Event (MUE) policies
• Strong understanding of data security and patient confidentiality issues
• Ability to work within a team environment as well as work independently

• Oversees coding programs and processes to support the revenue cycle strategy.
• Manages external vendor relationships and budgets.
• Reconciles daily file transfers to all outsourced coding vendors.
• Monitors coding productivity for all outsourced entities, assesses coding backlogs and validates that the vendor is meeting all production service level agreements.
• Reviews coding quality reports provided by the vendor and validates that the vendor is meeting all quality service level agreements.
• Develops action plans where productivity and quality do not meet service level agreements.
• Reconciles monthly invoices to work completed and achievement of service level agreements.
• Addresses inquiries from parents, insurance companies, and revenue cycle staff regarding coding and charging for assigned entities.
• Main point of contact between coders and providers for documentation related queries.
• Creates, manages, and executes project scope, schedule, resources, and change management initiatives.
• Communicates and documents project plan, status updates, business goals, and governance plan to team and stakeholders effectively.
• Identifies and manages project risks, issues, and opportunities.
• Collaborates with internal and external partners on assigned tasks as the subject matter expert for assigned responsibilities and activities.
• Ensures project deliverables are completed on time, of a high quality, and on budget.
• Develops and maintains strong working relationships with clinical teams.