[Hiring] Coding Manager @UMass Memorial Health

Role Description

Plans, organizes, monitors and manages coding function for professional and facility billing across multiple surgical/procedural specialties to ensure maximized revenue through effective billing and collection processes.

• Responds to and resolves complicated coding requests/questions from providers, Department Administrators and CBO staff.
• Communicates regularly with the PB CBO Managers to maximize reimbursement, effectiveness and efficiency of overall office function and performances.
• Participates in educational sessions for providers, Department Administrators and PB CBO Staff.
• Develops and implements standardized coding, charge entry and billing business rules and processes.
• Monitors and implements changes to ICD/CPT coding requirements and determines impact of such changes on current billing practices along with development of action plans to ensure compliance with said changes.
• Ensures that performance of the coding staff meets or exceeds performance standards to ensure maximized and timely reimbursement of services.
• Writes and maintains departmental processes and reference guides to ensure correct coding standards and effective, timely claims processing.
• Performs periodic coding and charge audits to ensure compliance with insurance rules and regulations and summarizes and presents findings to appropriate personnel.
• Maintains proper coding database for reimbursement measurement.

Qualifications

• Bachelor’s degree and 7-10 years of Healthcare experience required.
• Five years of coding experience and certification in physician-based coding.
• Minimum of 4 years managerial experience within a physician billing setting required.
• Demonstrated leadership ability, initiative, teamwork and assertiveness.
• Excellent verbal, written and interpersonal communication skills.
• Computer skills and ability to access and use multiple data systems including various PC applications, e.g. Excel, Word, Access and Power Point.
• Extensive knowledge in ICD and CPT coding, 3rd party payer requirements and federal and state guidelines and regulations pertaining to coding and billing practices.
• Proven analytical, research and evaluation skills required to make recommendations and implement operational improvement strategies as part of a cohesive team.
• Ability to effectively interact with various people and adhere to team management concepts.
• Must maintain current knowledge of coding and billing practices through reading of newsletters, publications and attendance at seminars.
• Must have the ability to maintain a positive attitude and professional manner when interacting with team members, management and other staff members.

Requirements

• Directs and supervises assigned personnel including performance evaluations, scheduling, orientation, and training.
• Makes recommendations on employee hires, transfers, promotions, salary changes, discipline, terminations, and similar actions.
• Resolves grievances and other personnel problems within position responsibilities.
• Develops and recommends the budgets for the areas managed.
• Manages activities to assure financial goals are met.
• Coordinates the assignment of tasks and helps resolve technical and operational problems.
• Evaluates the impact of solutions to ensure goals are achieved.
• Provides effective direction, guidance, and leadership over the staff for effective teamwork and motivation.
• Encourages and supports diverse views and approaches, demonstrates Standards of Respect.
• Integrates diversity into departmental objectives, such as hiring, promotions, training, vendor selections, etc.
• Participates in performance improvement initiatives and demonstrates the use of quality improvement in daily operations.
• Ensures compliance with regulatory agencies such as Joint Commission, DPH, etc.
• Develops and maintains procedures necessary to meet regulatory requirements.
• Ensures that department complies with hospital established policies, quality assurance programs, safety, and infection control policies and procedures.
• Ensures adequate equipment and supplies for department.
• Develops and maintains established departmental policies, procedures, and objectives.
• Ensures compliance to all health and safety regulations and requirements.
• Maintains regular, reliable, and predictable attendance.
• Performs similar or related duties as required or directed.

Benefits

• This position may have a signing bonus available; a member of the Recruitment Team will confirm eligibility during the interview process.