Manager of Coding Operations
RemoteCalifornia, United States or Kentucky, United States
Job Summary
Manage assigned coding operations across inpatient, outpatient, emergency, and ambulatory services, ensuring compliance with federal, state, and payer regulations while achieving organizational quality, productivity, and reimbursement accuracy benchmarks. Directly oversee Discharged Not Final Billed accounts, coding work queues, and revenue cycle edits, collaborating with Revenue Integrity and Clinical Documentation Integrity to resolve discrepancies and reduce billing delays. Schedule staff, monitor performance metrics, and lead second-level reviews for high-risk accounts to maintain operational continuity and turnaround time goals. Maintain extensive knowledge of ICD-10-CM/PCS guidelines, NCCI edits, and coverage determinations to assign accurate codes and support revenue integrity initiatives.
Required Qualifications
- Must reside in one of the States listed below to be eligible for this position: Arkansas, California, Kentucky, Massachusetts, Nevada, New Mexico, Oregon, Utah, Tennessee, Texas, Wyoming
- Associate degree in Health Information Management, Health Information Technology, Nursing, Business Administration, Healthcare Administration, or a related healthcare field required
- Minimum of five (5) years progressive acute care coding experience, including inpatient and outpatient coding
- Demonstrates extensive knowledge of Official ICD-10-CM/PCS Coding Guidelines, UHDDS, MS-DRG and APR-DRG assignment methodologies, OPPS, IPPS, APC reimbursement methodologies, Coding Clinic, CPT Assistant, HCPCS Level II, Medicare Claims Processing Manual, Medicare Benefit Policy Manual, National Correct Coding Initiative (NCCI) edits, National Coverage Determinations (NCDs), Local Coverage Determinations (LCDs), and commercial payer coding and reimbursement requirements
- Proficient in Microsoft Office Suite (Word, Excel, Outlook, OneNote, PowerPoint), Microsoft Teams, encoder software, electronic health records, coding abstraction systems, auditing software, reporting tools, and other revenue cycle applications required to perform assigned responsibilities
- Demonstrates excellent verbal, written, presentation, facilitation, conflict resolution, coaching, and interpersonal communication skills
- Demonstrates exceptional organizational, analytical, critical thinking, prioritization, and time management skills
- Maintains extensive knowledge of anatomy, physiology, pathophysiology, pharmacology, disease processes, surgical procedures, diagnostic testing, medical terminology, clinical documentation, and reimbursement methodologies
Desired Qualifications
- Bachelor's degree preferred
- Three (3) or more years of coding leadership, supervisory, management, auditing, education, or project leadership experience
- Demonstrated experience managing coding productivity, coding quality, regulatory compliance, physician documentation issues, coding denials, revenue cycle initiatives, and operational improvement
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