[Hiring] Manager Professional Billing Coding Operations @BMC Software

Role Description

Responsible for the operational functions of the Professional Coding Operations team for BUMG. Plays a strategic role in validating the accuracy of CPT, HCPCS and diagnosis code assignment by coders, physicians and non-physician practitioners. Works closely with key revenue cycle stakeholders to understand reasons for denials, root cause analysis, and feedback to providers. Supervises professional billing coding staff.

• Partners with Coding Education Team to identify trends in coding practices and assists with developing feedback and education to providers.
• Reviews coding denials to resolve and identify trends and provides feedback to providers and departments.
• Performs quality assurance reviews of inpatient and outpatient records to assess and report on the effectiveness of training programs and quality of coders.
• Provides in-service training and feedback to coding staff regularly, including coding changes and updates.
• Oversees coding operations to ensure organizational goals are being met.
• Partners with the Coding Education Team to design and implement programs on coding and clinical documentation audit and education to improve performance and efficiency.
• Enforces correct application of Official Coding Rules and Regulations and follows appropriate guidelines.
• Oversees the coding edits and denials and ensures compliance with payer guidelines.
• Responsible for supporting coding related, RAC, other external coding reviews, and denials related to coding.

Qualifications

• Bachelor’s degree or equivalent combination of formal education and experience.
• CPC – Certified Professional Coder.

Requirements

• At least five years of experience in coding; experience must include education/mentoring/training.
• Minimum of five years acute care hospital experience coding with ICD-10-CM and CPT-4, academic medical setting or trauma center preferred.
• Minimum of three years management experience required; five years preferred.
• Prior experience working claim edits and denials.

Benefits

• Generous total compensation that includes benefits (medical, dental, vision, pharmacy).
• Discretionary annual bonuses and merit increases.
• Flexible Spending Accounts.
• 403(b) savings matches.
• Paid time off.
• Career advancement opportunities.
• Resources to support employee and family well-being.