Gastro Health

Coding Operations lead

Gastro Health$75K — $95K *
Miami, FL 33186In-Person
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 5+ years of experience in healthcare billing and coding
  • 2+ certification in coding (CPC, COC, CRC, CPMA, CGIC)
  • Associate's or Bachelor's degree preferred (experience can substitute education)
  • Background in managing large teams and supporting over 100 healthcare providers
  • Proficient with large Practice Management Systems (eCW preferred)
  • Experience with data analytics tools like Visiquate and Power BI
  • Extensive knowledge of billing compliance and regulatory coding guidelines.

Responsibilities

  • Oversee daily operations of the Coding Department teams
  • Prioritize and manage workloads to meet KPIs
  • Develop front-end edits and manage denial resolutions
  • Enhance team effectiveness through streamlined initiatives
  • Conduct team audits to maintain quality standards
  • Identify trends in claims denials and underpayments
  • Train and motivate team members while maintaining performance metrics.

Benefits

  • Work/life balance
  • Opportunities for internal advancement
  • 401(k) retirement plans
  • Profit-sharing options
  • Comprehensive health insurance (medical, dental, vision)
  • Life and disability insurance
  • Paid time off and holidays
  • Pet insurance option.
Full Job Description
This role is responsible for the daily oversight and supervision of designated Coding Department teams, ensuring efficient workflows, compliance with coding guidelines, and achievement of key performance indicators (KPIs). Key duties include prioritizing workloads, supporting denial management efforts,

Job Description:

    • Directly oversees and supervises day to day operations of designated Coding Department teams.
      • Prioritize, assess, and re-prioritize daily workflows to ensure timely execution of Coding and meeting/exceeding goals/KPI.
      • Assist with creation of front-end scrubs/edits based on coding guidelines and denial management review.
      • Effectivity manages the team through streamlined improvement initiatives to ensure the team is highly effective for the providers.
      • Actively participates and maintain strong new hire training process and assist with policy/procedure documentation and process workflow.
      • Conduct audits of team members to ensure quality initiatives are being met and exceeded.
      • Identify and document trends in underpayments, denials, aging receivable that compromise the ability of the Coding team to meet established goals.
      • Assists with resolution of complex claims or projects and trains team to improve follow up efforts.
      • Strong analytical skills to prepare project data with external payors and partners.
      • Motivate, train, evaluate, record and report team members performance and progress.
      • System matter expert of all Coding functions across the team to maintain a highly efficient and productive team and to ensure process can be trained effectively.
      • Assist Management in establishing weekly/monthly goals, ensure Coding team members are utilizing all resources and meeting and/or surpassing weekly/monthly KPI's.
      • Assist manager with preparing weekly and monthly RCM reporting metrics to remediate any items outside established KPI including status report of projects.
      • Research and maintain understanding of policy changes across the RCM markets.
      • Daily reviews of the following programs: Incoming claim/denial volumes, daily billing, rejections, evaluate clean claim rates, and team workflows.
      • Assist manager in the interview process.
      • Assist with preparation of team meetings focused on collaboration and process improvement.
      • Assist Manager with employee performance appraisals and work with the coding team on skill development.

Minimum Requirements;
• More than 5 years' experience/Seniority with healthcare billing
• 2 or more applicable Coding Certificates (CPC, COC, CRC, CPMA, CGIC) *Does not apply to data entry Lead*
• Associates or Bachelor's Degree is highly preferred but experience may be substitued for education
• Experience with a large, growing healthcare organization supporting 100 or more providers and overseeing 10+ team members
• Experience with a large Practice Management (PM) System, eCW (E Clinical Works) is a plus but not required
• 5+ experience in healthcare industry and 1+ years of supervisory experience/leading a team, in Billing/Coding roles
• Able to run open claims reports in Visiquate for coder distribution. Analyze productivity report to assure action plan and expectations are met by coding team. Responds to RCM Care Center and Internal Request smartsheet. Provides routing coder audit for quality assurance
• Utilizes Visiquate, Power BI and reconciliation reports to upload and analyze data to align all Coding benchmarks and identify support areas and coverage
• Extensive knowledge of patient registration, coding guidelines, billing, regulatory requirements, billing compliance

This position offers a great work/life balance!

We are growing rapidly and support internal advancement

We offer competitive compensation

401(k) retirement plans

Profit-Sharing

Dental insurance

Health insurance

Life insurance

Paid time off

Vision insurance

Disability insurance

Pet insurance

We offer a comprehensive benefits package to our eligible employees, which includes: Cigna healthcare, dental, vision, life insurance, 401k, profit-sharing, short & long-term disability, HSA, FSA, and PTO plus 7 paid holidays.

About Gastro Health

Gastro Health is a leading medical group made up of the finest physicians and allied health professionals in South Florida specializing in the treatment of gastrointestinal disorders, nutrition, and digestive health. With locations throughout Miami-Dade, Broward, Palm Beach, and St. Lucie counties, Gastro Health is committed to providing its patients with the highest quality care possible.
Learn more about Gastro Health
Size
1,500 employees
Industry
Net Income
$10 million
Founded
2006
5 Year Trend
+20%
Revenue
$200 million

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