Medical Coding Manager

The Medical Coding Manager oversees coding functions. Managing submissions by the Medical Coding Specialist and CAH Coder. The Medical Coding Manager is experienced in electronic medical records and is able to provide oversight to all coding areas in accordance with the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and in compliance with ICD-10 Official Coding Guidelines and other regulatory requirements.

Position Requirements

Licensure/Certification/Registration: Experience with Revenue Cyle and Professional and Technical coding guideline.

Education: High school diploma or equivalent and graduate of or extensive experience in revenue cycle.

Experience: Compliance with Medicare Critical Access Hospital reimbursement guidelines. Five years of Critical Access coding, CDM updates, NCCI edits and complete understanding of Professional and Technical components, inpatient facility coding, ancillary coding. Reimbursement guidelines and compliance with CMS and other regulatory requirements.

Principle Duties and Responsibilities:

1. Manage Medical Coding Specialist and CAH Coder positions to include Hiring, Time management, mentoring, educating, payroll approvals, annual reviews and disciplinary actions.
2. Work with department leaders to improve processes and education regarding subjects related to coding and the revenue cycle.
3. Review, analyze and interpret the E.H.R. and provide support for coders.
4. Review clinical documentation to ensure accuracy and completeness for coding and compliance
5. Assist with the Query providers for clarification or additional documentation to support accurate coding and DRG assignment if initial response is not provided.
6. Collaborate with physicians and clinical staff to improve documentation quality and specificity
7. Analyze coding reports, for opportunities to capture severity of illness, risk of mortality, and appropriate reimbursement
8. Monitor and track CDI queries and responses for compliance and reporting purposes
9. Assist with educating providers on documentation best practices and coding requirements
10. Ensure adherence to regulatory guidelines and hospital policies related to documentation and coding
11. Participate in audits and quality improvement initiatives related to CDI
12. Ensure Productivity and Qualify of all coders is addressed monthly and reports are available for review.  Address all educational needs and remain updated regarding the constant changes related to regulations and industry trends and outlooks, in order to proactively response to those changes.
13. Actively participate in any revenue cycle changes within the facility.
14. Review and implement improvement projects
15. Design and implement Productivity standards and Qualify standards.
16. Provide monthly education meetings for all coders, to include, but not limited to trends with a provider, technical coding issues, Order set pricing discrepancy.
17. Responsible for the oversight of updates to CDM.