Job Posting DescriptionPosition Summary
Manages and supports specialty and medical coding for Physician Organization Shared Services' professional billing and collection functions. This is a hands-on coding leadership role overseeing daily coding operations, supervising and supporting coding staff, ensuring accuracy and compliance, and partnering with physicians and billing leadership to improve coding and reimbursement.
The ideal candidate must have a CPC certification (CPC-A candidates will not be considered) and a strong surgical physician/professional coding background. Hospital/facility coding alone does not meet the requirement. Previous coding management or supervisory experience is required, with approximately 5 years preferred, along with strong Epic and coding system edit experience.
A key focus will be denial management, including identifying root causes, resolving coding and billing issues, and implementing process improvements to reduce recurring denials. The Supervisor/Manager will also provide hands-on coaching, training, and guidance to the coding team while collaborating with physicians and leadership to improve billing accuracy.
Key Responsibilities
- Manage coding operations, work assignments, and workflows to ensure accurate and timely processing of charges, appeals, and reports.
- Lead and supervise assigned coding staff, including hiring, onboarding, training, performance management, and annual reviews.
- Ensure coding accuracy and compliance with ICD-10-CM, CPT, and HCPCS guidelines.
- Resolve missing or incomplete coding information, coding queries, and issues escalated by coding staff.
- Review coding and billing reports to identify performance issues, errors, and opportunities for improvement.
- Analyze billing system issues and work with leadership and vendors to resolve problems and maintain data integrity.
- Develop and implement coding policies, procedures, training, and workflow improvements.
- Monitor changes in coding, billing, and payer requirements and update processes accordingly.
- Support EPIC coding training and help ensure consistency and compliance across coding practices.
- Partner with physician leadership, department administrators, pricing/contracting, quality teams, and billing leadership on coding and billing initiatives.
- Review audit and chart-review findings and make recommendations to improve coding accuracy and reimbursement.
- Serve as a coding expert and resource for the Billing Management Team and physician organization.
Minimum Qualifications
- Certified Professional Coder (CPC) OR Certified Coding Specialist - Physician-Based (CCS-P) certification required.
- Strong knowledge of physician/professional coding and billing.
- Knowledge of ICD-10-CM, CPT-4, and HCPCS coding systems.
- Knowledge of medical terminology, anatomy and physiology, pathophysiology, and healthcare regulatory requirements.
- Advanced knowledge of CCI, LCD, and CMS RVU/PRVU.
- Strong analytical and problem-solving skills.
- Ability to manage and lead employees effectively.
- Strong communication, negotiation, and conflict-resolution skills.
- Ability to work effectively with diverse internal and external teams.
- Computer literacy and experience with computerized billing systems required.
Education:
Associate's Degree required
Area of Study: Medical Records
Experience:
3 years of coding experience in DRG Validation and/or compliance review within a multi-specialty setting.
Schedule: remote
