What are the responsibilities and job description for the Coding Operations Manager position at Prestige Billing Services?
Position: Coding Operations Manager
Education: Certified Professional Coder (CPC minimum) or Certified Emergency Department Coder (CEDC preferred)
Experience: Equivalent of an Associate’s degree and two to three years of relevant emergency department or general medical coding experience.
OVERVIEW
Coding operations manager is responsible for overseeing the medical coding team and ensuring the accurate and efficient coding of patient records for billing, compliance, and reimbursement purposes. Oversee insurance verification department. Needs skills with operational leadership, compliance oversight, team management, and process improvement within the healthcare revenue cycle.
JOB RESPONSIBILITIES
CODING OPERATIONS AND OVERSIGHT
- Oversee day-to-day operations of the medical coding team, ensuring timely and accurate coding of diagnoses, procedures, and services
- Ensure that all codes (ICD-10, CPT, HCPCS, etc.) are applied correctly and consistently according to official coding guidelines
- Distribute work evenly among coders based on volume, complexity, or specialty
- Manage team schedules, collaborate with HR regarding time-off requests, and ensure adequate coverage
COMPLIANCE AND QUALITY ASSURANCE
- Conduct regular internal/external audits to ensure compliance with federal regulations (e.g., CMS, HIPAA) and payer requirements address issues discovered
- Stay current with updates/coding changes and educate staff on changes as needed, train new coding staff members
- Research and Development of Compliance and Coding Standards
- Assist in ensuring that the coding guidelines and processes for new clients adhere to all legal and regulatory requirements specific to the medical industry, creating a seamless integration for new contracts
TEAM LEADERSHIP AND DEVELOPMENT
- Provide training for new hires and ongoing education for existing staff
REPORTING AND METRICS
- Track coding productivity and quality metrics (e.g., charts coded per day, accuracy rates)
- Prepare reports for upper management regarding coding efficiency, denial trends, audit outcomes, etc.
- Identify trends, issues, or bottlenecks through performance data and propose process improvements
CROSS-FUNCTIONAL COLLABORATION
- Work in collaboration with the RCM team to resolve any coding/insurance verification related issues by working closely with team members and other departments to implement solutions
- Collaborate with providers to clarify documentation and coding queries. New physician and APP education
- Work with the Operations Director to monitor the financial health of the company
PHYSICAL REQUIREMENTS
- Must be able to lift up to 15 lbs.
- Prolonged periods of sitting at a desk on a computer
- Local residency required