Job Description:Role Summary:The Coding Manager is responsible for policies and procedures, performance, and oversight of the coding team. This role is responsible for managing daily operations, achieving productivity metrics and ensuring goals are met. The Coding Manager will train and mentor the team as well as onsite provider training, as required. The manager will be responsible for researching new lines of business and advising management of pertinent coding regulations.
Responsibilities: - Manages the coding and audit department developing policies and procedures and ensuring corporate compliance to coding guidelines. Discusses coding results with physicians and Executive Leadership providing input on quality improvement.
- Analyze data, identify issues, reach conclusions, and propose strategies for resolution of complex coding issues, along with leadership. Meet with physicians to train on new lines of business and set up charge capture workflows.
- Responsible for researching billing and coding guidelines for new or current service lines.
- Responsible for overseeing E&M and CPT coding audits, physician education training and other projects related to physician coding compliance in fulfillment of the practice's compliance program.
- Complete all quarterly PEx plans and deliver feedback to the staff including quarterly coaching.
- Keeps informed regarding current billing and coding regulations, auditing, professional standards and company/department policies and procedures and effectively applies this knowledge and disseminates to staff and other management team members.
- Keeps informed of HCC coding regulations and manages the HCC workflow within the department alongside the Care Transformation team.
- Successfully leads and mentors the team, provides coding education and training.
- Identifies process improvement opportunities that enhances the performance of the department.
- Responsible for ensuring the team meets and maintains the company standard for coding performance and quality.
- Provides performance management/corrective action when productivity and quality goals are not met.
- Partners with the management team to ensure compliance with all federal, state and local regulations.
- Participate in management meetings and hold regular department meetings reviewing department performance and quality outcomes.
- Responsible for reviewing medial documentation for accuracy.
- Identify and communicate documentation deficiencies to providers to improve documentation to accurate risk adjustment coding and compliance
- Evaluate and optimize end to tend practice clinical documentation and coding workflows
- Assist in various projects given by the Director of Patient Accounting, Assistant Director of RCM or other leadership.
- Additional responsibilities may be assigned to help drive our mission of improving the lives of everyone living with cancer.
Required Qualifications: - CDEO or CDIP and CPC or Other Coding Certification required
- Thorough knowledge of ICD- 10-CM, CPT, and HCPCS coding principles associated with Official Coding Guidelines and regulatory requirements.
- Minimum 3 years health care management/leadership experience required.
- Minimum 3 years medical coding and auditing experience.
- Must have effective written and verbal communication skills.
- Bachelor's Degree in Health Information Management or associated healthcare field of study preferred.
Essential Competencies: - Attendance is an essential job function.
- Thorough knowledge of ICD- 10-CM, CPT, and HCPCS coding principles associated with Official Coding Guidelines and regulatory requirements.
- Knowledge of third-party payer regulations.
- Excellent written and verbal communication skills.
- Ability to apply good judgment.
- Ability to meet deadlines.
- Knowledge of clinic office procedures, medical practice and medical terminology.
- Ability to interpret, adapt and apply guidelines and policies and procedures.
- Ability to successfully organize, delegate, and supervise.
- Ability to recognize, evaluate and solve problems.
- Ability to successfully plan, implement and manage multiple projects simultaneously.
- Strong organizational skills and attention to detail.
- Strong knowledge of Windows-based software applications. (E.g.: Word, Excel, Outlook...)
- Excellent Customer Service skills.
The above job description is a general overview of the responsibilities and competencies for this role at OneOncology. Specific details may vary based on the needs of the organization.
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