Role Description
The Coding Manager is responsible for ensuring timely, accurate, consistent, and compliant coding through appropriate direction, training, auditing, and supervision of the Coding staff. This position oversees coding quality and compliance with applicable federal and state regulations, payer requirements, industry standards, and NPH policies and procedures. The Coding Manager provides daily, weekly, and monthly reports to management as requested and supports continuous improvement of coding processes to promote accuracy, compliance, and operational efficiency.
Essential Duties and Responsibilities
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Manage the Coding team including, but not limited to, hiring, training, managing, evaluating team performance, and conducting professional development plans.
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Provide training and ongoing education, annual reviews, and performance monitoring for all coders, including education related to coding compliance, regulatory updates, payer requirements, and industry standards.
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Develop, implement, and monitor compliance policies and procedures for the Coding team to ensure adherence to applicable laws, regulations, payer requirements, and company standards.
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Ensure coding practices are consistent with applicable CMS, Medicare, Medicaid, Workersβ Compensation, payer, and industry requirements.
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Ensure coders maintain accurate and complete documentation to support billed services and assigned CPT, ICD-10, HCPCS, and ASA codes.
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Monitor coder productivity, accuracy, quality, and compliance. Communicate standards and performance expectations.
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Monitor turnaround time for coding completion and ensure coding is completed within established operational and compliance standards.
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Monitor concurrency daily and identify trends or issues requiring corrective action.
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Provide coding guidance to physicians, CRNAs, and other providers regarding documentation, coding requirements, and compliance standards.
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Audit coding work queues and maintain appropriate quality standards, including CPT, ICD-10, ASA, and HCPCS coding.
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Conduct and/or coordinate routine coding audits to identify coding errors, documentation deficiencies, compliance risks, and opportunities for education or process improvement.
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Review audit findings and implement corrective action plans, retraining, and follow-up monitoring as appropriate.
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Maintain current knowledge of federal and state healthcare regulations, CMS requirements, payer policies, coding guidelines, and industry standards affecting anesthesia and pain management coding.
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Identify, escalate, and assist in resolving potential coding compliance concerns, billing discrepancies, or other issues that may create regulatory, financial, or operational risk.
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Support internal and external audits, payer audits, compliance reviews, and other regulatory inquiries related to coding activities.
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Maintain knowledge and understanding of billing systems, coding software, and automation daily processes to ensure accurate and compliant workflows.
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Maintain strict confidentiality and protect patient health information in accordance with HIPAA and company privacy and security requirements.
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Adhere to all company policies and procedures, including applicable compliance, privacy, security, and information systems policies.
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Mentor employees, conduct performance evaluations, counsel, provide disciplinary actions to assigned personnel, and work to facilitate individual and team development that drives positive results.
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Continually identify process improvement methods and opportunities to automate processes to increase efficiency while maintaining coding accuracy, quality, and compliance.
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Maintain appropriate documentation of coding audits, education, corrective actions, and compliance activities.
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Monitor coding trends and regulatory changes and communicate relevant updates to leadership and the Coding team.
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Perform other duties as assigned.
Qualifications
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Bachelorβs degree in a business or health-related field. Will consider a combination of education and work experience equivalent.
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Professional Coding Certification (i.e., CPC, CCS) required.
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Additional coding, compliance, auditing, or healthcare revenue cycle certifications are preferred.
Requirements
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3β5 yearsβ experience in the healthcare industry with upward mobility documented.
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2β3 years of Anesthesia experience required.
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2β3 years of supervisory experience preferred.
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Experience performing coding audits, monitoring coding compliance, and/or developing corrective action plans preferred.
Benefits
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Competitive Pay and Benefits Package
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Annual Bonus
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Generous Paid Time Off
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401K Contribution/Safe Harbor
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Flexible Work Environment
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Career Advancement Opportunities with a Growing Company