Medical Records Coding Manager

Duties/Responsibilities:

• Oversees the day-to-day activities, such as staffing, workflow, work routine and special projects, and makes the changes as necessary.
• Ensures the Coding Department provides timely and accurate administrative and clinical data to ensure optimum reimbursement via random review of coded records.
• Ensures coders meet quality expectations while ensuring DFNB meets expectations.
• Training and in-servicing of coding staff in current coding and reimbursement methodologies (i.e., ICD-10, DRG/APCs/Medical Necessity Policies)
• Assists staff in working Billing Scrubber reports for medical necessity, modifier issues.
• Participates in audits and appeals with the various insurance carriers, including RAC audits.  Audits, works closely with Patient Accounts Department.
• Manages Coding Staff, including interviewing, hiring, performance appraisals, and recommendations. Evaluates staff during probationary period to determine if successful completion of probationary period is appropriate.
• Interacts with physicians, hospital staff, and ancillary staff.
• Serves as liaison between the HIS Department and Patient Accounts Department and Case Management.
• Collaborates with the Documentation Specialist Team to provide the most accurate coding for reimbursement.
• Queries physicians when code assignments are not straightforward or record documentation is inadequate, ambiguous, or unclear for coding purposes.
• Maintains knowledge of medical record functions in addition to expert coding knowledge.
• Embraces technological solutions to work processes and practices.
• Assists Director in daily operations of the department.
• Participates on Hospital Committees (i.e., Revenue, RAC, Medical Records, UR)

It is understood that this is a summary of key job functions and does not include every detail of the job that may reasonably be required.

Education/Experience Required:

• 3-5 years of hospital coding, including ICD-9-CM and CPT-4.  Thorough knowledge of ICD-10 and PPS and reimbursement requirements.  Ability to supervise staff, develop training programs, accurately assess staff performance, and communicate effectively.  Subject matter expert in Medical Terminology, Anatomy, and Physiology. 
• Associates Degree or equivalent in Health Information Technology  

Registration/Certification:

• RHIA/RHIT and/or CCS required
• AHIMA ICD-10 Train the Trainer Certification preferred