Coding Manager

Job Title: Coding Manager
Reports to: Director of Coding

Position Summary:

The Coding Manager reports to and partners with the Director of Coding to provide oversight and management to the Coding staff. They will ensure staff follow operational standards on efficiency, accuracy, compliance, and productivity and are held accountable for current processes.
Coding manager will collaborate with QA auditors to ensure quarterly audits are completed on schedule, review audit outcomes for accuracy and compliance and analyze audit trend to guide corrective action planning. Serves as a resource for department staff, physicians, and administration to obtain information or clarification on accurate coding and documentation standards, policies, and regulatory requirements.

Key Responsibilities:

• Number of direct reports: 27, including 4 leads
• In-office days: Remote, in-office as needed for required meetings

Essential Duties and Responsibilities:
• Ensure all staff are meeting productivity and quality goals. Evaluates staff quality assurance (QA) audit results and works collaboratively with Director and QAs to identify and/or design instructional resources to improve performance.
• Ensures training programs are sufficient to support staff and facilitate effective performance.
• Ensure physician feedback is regularly provided, and coding support is made available, as necessary by coordinating and communicating key issues, charge status, or other information, as necessary and appropriate.
• Serves as subject matter expert for evaluation and management and procedural coding.
• Interacts regularly with coding leads, physicians, and vendors to ensure understanding of coding and documentation guidelines/principles, as well as government and commercial payer rules and regulations.

• Assist with maintenance of claims manager application to ensure rules are appropriately capturing billing instances that would result in claim denial.
  • Conduct investigatory meetings of potential work rule violations to address personnel issues with HR.
  • Works with Coding leads to counsel coding team on actions required to meet minimum performance requirements.
  • Provides necessary knowledge-based resources required for the Coding team to meet quality and production standards.
  • Works with auditors to ensure internal and vendor audits are completed timely and to create ongoing education training and refreshers to ensure compliance with changes and current coding and documentation requirements.
  • Develop and execute Coding process improvement projects.
  • Monitor and evaluate the work of coding leads on a regular basis to ensure that work is performed accurately and in a timely manner.
  • Ensure productivity and actions of the Coding team meet and support the overall operational goals of the department and institution.
  • Utilize reports, dashboards, and other accessible tools to manage work volume, trends impacting the coding team.
  • Submit IT requests to resolve WQ related issues.
  • Other duties as assigned.

Knowledge, Skills & Abilities:
• Knowledge – knowledge of medical terminology, coding, and office procedures.
• Communication - communicates clearly and concisely, verbally and in writing.
• Persistence – comfortable pursuing, rebutting, and escalating issues as appropriate.
• Goal-oriented – holds him/herself accountable to achieving shared professional and personal goals.
• Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.
• Interpersonal skills – establishing and maintaining effective working relationships with employees, patients, and external parties.
• PC skills - demonstrates high proficiency in Microsoft Office applications, especially Microsoft Excel, and others as required.
• Writing skills –advanced writing skills with ability to present a compelling argument, punctuate properly, spell correctly, and transcribe accurately.

Education/Experience:
Bachelor’s degree in Business Administration, Healthcare Administration, or related field required. Current certification(s): RHIA, RHIT, CCS, CPC-H, CCS-P, CIRCC, CPC, AHIMA-approved ICD-10 trainer, or equivalent coding certification required. Multiple certifications preferred.

Minimum four to five (4-5) years of coding experience in Physician billing healthcare Revenue Cycle required. Minimum of three (3) years coding management experience preferred. Revenue cycle role in physician environment in an academic healthcare setting preferred.

Experience should also demonstrate expert-level knowledge of CPT/ICD10, third-party reimbursement guidelines and methodologies, highly effective management and team-building skills, and demonstrated commitment to quality improvement. Must have the ability to analyze and interpret data, good problem-solving skills, and initiative. Must have experience in conducting coding audits and reviews.