Job Requirements Under minimal supervision from the Senior Manager of OP Coding, the outpatient coding manager is responsible for overseeing the daily operations of the outpatient coding department to include the specialties of Ambulatory Surgery, Observation, Emergency Room, Series, Clinics, Claim Edits, and other outpatient encounters. This role involves managing a team of outpatient coding professionals and ensuring appropriate reimbursement, research, and compliance with federal and state regulations according to established ICD-10 CM and CPT-4 procedure coding classification systems across UMMS Health System. Collaborating with other departments to optimize the revenue cycle process is crucial to this role.
The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.
- Manages, plans, organizes, monitors, and evaluates the outpatient functions to ensure effective and efficient operations and compliance with established standards, rules, and regulations.
- Serves as a clinical coding subject matter expert and utilizes critical thinking to analyze and evaluate documentation issues with consultation from Clinical staff, Clinical Documentation Specialists, and Coding Quality as needed.
- Oversees the day-to-day management of outpatient coding operations. Manages accounts receivables daily to facilitate the billing process within the established timeframes across the health system.
- Identifies and ensures accurate assignment of ICD-10 CM diagnostic codes and CPT-4 procedure codes to outpatient, ambulatory surgery, observation, emergency room, series, clinics, and other OP visits for the purpose of reimbursement, research, and compliance with federal and state regulations.
- Identifies coding risks and/or client issues and problems proactively and make appropriate recommendations.
- Maintains appropriate coverage and associate workload. Engages contract coders and/or overtime as needed to maintain appropriate turnaround times.
- Manages the OP Coding Supervisor(s)/Team Lead(s) to maintain bill holds and achieve financial stability of organization.
- Manages coding productivity and coding quality reports for assigned specialties and holds associates accountable for their performance.
- Works collaboratively with ancillary departments, pathology, and other ambulatory departments to ensure accurate documentation to achieve optimal coding proficiency and accuracy.
- Oversees coders' achievement within established standards:
- Coding quality accuracy rate of 90%.
- Productivity rate of 95%.
- Communicates with various departments within the hospitals regarding billing and registration issues for specific areas of oversight. Serves as a clinical coding liaison and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, Coding Quality team, and clinical documentation team as needed.
- Participates in corporate and local facility meetings as needed to support the outpatient coding function.
- Manages staff job performance, attendance, and quality issues. Communicates with the Coding Quality Team to work on best practices to meet the individual coder training needs.
- Hires employees and oversees orientation and training of new coders. Conducts performance evaluations, handle corrective actions, and provides an open and goal-oriented work environment with established clear and concise work procedures and productivity standards.
- Assists and trains coders on areas identified from audits and develop and implement ongoing education programs for coding staff. Reviews recommendations from supervisors/team leads and provides guidance or counseling to staff regarding employee relation matters.
- Complies with AHIMA standards of ethical coding and coding compliance guidelines.
- Demonstrates support and compliance with University of Maryland Medical System mission, vision, values statement, goals and objectives and policies. Performs other duties or projects such as assigned. Attends seminars and in-services as required to remain current ongoing issues.
Work Experience - Associate degree and 7 or more years of experience with coding facility outpatient medical records is required. Relevant facility coding experience may substitute the required education on a year-for-year basis. Bachelor's degree in related field is preferred.
- 3 years'supervisory experience/management experience required in the coding field.
- Managing multi-facility coding departments preferred.
- One of the following: Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA).
Knowledge, Skills, and Abilities Strong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability.
