U.S. Orthopaedic Partners is Hiring a CODING MANAGER Near Alpharetta, GA
Essential Duties:
Provide leadership to coding review and charge capture staff.Ensure that equity of workloads, productivity goals and assignments are maintained. Assigns monthly benchmarks, weekly activities and daily priorities as appropriate to ensure timely completion of duties
Establish protocols to ensure Revenue Integrity
Plan and direct audits to evaluate the adequacy and accuracy of documentation in support of services billed, including CPT/ICD-10/HCPCS and other third-party payer codes, medical necessity of services, compliance with other documentation and coding and billing standards
Lead the evaluation of the adequacy and effectiveness of internal and operational controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to coding and billing, federal and state regulations and guidelines, CMS and other third-party payer billing rules, and OIG compliance standards
Establish and implement a physician education program to include documentation education
Serve as a subject matter expert and authoritative resource on interpretation and application of documentation and coding rules and regulations, and conduct enterprise risk assessments of potential and detected compliance deficiencies
Stay current on relevant coding and billing regulations and enforcement trends, specifically as they relate to provider-based coding and billing to include updates to key stakeholders
Develop standards and guidelines for medical record documentation including reporting on deficiencies and training to remediate
Collaborate with Compliance Officer on compliance, coding documentation and risk management when required
Partners with Chief Medical Officer on all coding related projects including but not limited to physician education, updated coding rules and best practices, research, etc.
Develop the annual compliance work plan sections relating to coding and billing
Work closely with company's physicians, Operations and Revenue Cycle Leadership to validate controls and monitor high risk areas
Perform coding and billing documentation and charge audits, according to best practices
Responsible for coaching, professional development, and mentoring coding and data entry staff
Develop documented policies and processes related to the management of coding and billing compliance matters
Develop edits within claims scrubber EHR software including testing and validation
Prepare and provide coding education to organization physicians, providers and staff
Responsible for effective identification of staffing resources, recruitment and allocation of resources
Provide guidance and motivation to staff regarding identification of activities/areas where performance can be improved
Responsible for making recommendations and/or decisions for hiring, corrective actions, terminations, and performance evaluations
Other duties as assigned by the Vice President of Revenue Cycle Management
Required Qualifications:
Certified Professional Coder- AAPC Certifications
Coding compliance experience
Bachelor's degree or equivalent work experience
Orthopedic physician practice and/or surgery center experience
Advanced Knowledge of:
Documentation, coding and billing rules/guidelines
CPT/ICD-10/HCPCS coding rules
Medical terminology and healthcare compliance audit requirements
CMS regulations and guidelines
Minimum of 3-5 years of management experience in a physician or healthcare MSO organization
Ability to manage and direct others in a fast-paced, team-oriented environment including remote indirect and direct reports
Excellent analytical, problem-solving and decision-making skills
Excellent communication skills (verbal, written & presentation)
Excellent computer skills with strong proficiency in reporting, spreadsheet applications and experience with Microsoft Office
Travel up to 25% as needed for practice support, coding audits, learning and development, coding team member coaching, etc.
The role is based in the Alpharetta, GA, office which follows a hybrid work structure where employees can work remotely or from the office, as needed, based on demands of specific tasks or deadlines, as determined by the manager. Working from the office is encouraged, at times required, for tasks that require a high degree of collaboration.
Preferred Qualifications:
Certified Orthopedic Surgery Coder
Physical Requirements: Physical requirements for the position include the ability to frequently hear and communicate orally, see up close and at a distance, read and comprehend, stand, sit, walk, reach, handle, and/or feel objects. Must be able to climb, pull, push and kneel. Maximum unassisted lift = 25 lbs. Average lift less than 10 lbs. Must be able to work extended hours as necessary.