The Manager, Coding will play a key role in reviewing and analyzing medical billing and coding for processing while assisting with client management and managing the coding team.
- Adheres to the ICD-9/ICD-10 coding conventions, official coding guidelines approved by CPT, AMA, AAOS, and CCI.
- Consults physicians for clarification and additional documentation prior to code assignment when there is conflicting or ambiguous data in the health record.
- Strives for the optimal payment to which the facility is legally entitled.
- Assists and educates physicians and other clinicians by advocating proper documentation practices.
- Adheres to OIG guidelines which include:
- Some centers require a code disagree form be completed. Coders are required to provide their supporting documentation to be presented to the center for approval. (Surg Centers call this a coding variance)
- Ensures the coding site specifics are updated as needed for each center assigned.
- Identifies and tracks all cases that are not able to be billed due to lacking information such as operative notes, path reports, supply information etc. On a weekly/daily basis provide a documented request to the center requesting the information needed.
- Responsible for properly performing month end tasks within the established timeframe including running month end reports for each center assigned and tracking of cases that are not yet billed for the month.
- Client management, including emails, phone calls, and video meetings with client staff as well as physicians
- Aid clients in denial management and coding reviews
- Manage a coding team consisting of Team Leads and production coders
- Productivity management of cases coded
- Approve employee time and payroll entries
- Provide training and ongoing education to coders
- Participate in meetings, trainings, and conferences as needed
- Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time
EDUCATION DESIRED:
High school graduate or GED certification
SPECIFIC KNOWLEDGE & SKILLS REQUIRED:
- Required certification in one of the following: CCS, CPC, RHIA, RHIT
- Successful completion of formal education in basic ICD-9-CM/ICD-10/CPT coding, medical terminology, anatomy/physiology and disease process
- Excellent command of written and spoken English
- Ability to promote favorable company image with patients, insurance companies, and general public
- Ability to solve problems associated with assigned task
- Minimum of 5 years acute care coding experience of all patient types Inpatient, SDS and ER, with strong experience in Surgical coding
- 3 years management experience
- Strong attention to detail and speed while working within tight deadlines
- Exceptional ability to follow oral and written instructions
- A high degree of flexibility and professionalism
SPECIFIC KNOWLEDGE & SKILLS REQUIRED:
- Experience working in an Ancillary/Ambulatory Surgery Center (ASC)
- A working knowledge of IPAs and health plans is required.
- Comfortable with electronic and manual payor follow-up.
- Able to quickly identify trends and escalate, as appropriate.
- Ability to read, analyze and interpret insurance plans, financial reports, and legal documents
BENEFITS:- Benefit package including Medical, Vision, Dental, Short Term Disability, Long Term Disability, and Life Insurance
- Vacation/Sick time
- 401(k) retirement plan with company match
- Paid Holidays
- SIS Cares Day
- Hybrid environment depending on the role
