Coding and Documentation Manager
About the role
UNT Health Clinical Practice Group is the academic clinical practice for UNT Health. Focused on improving health outcomes to build a healthier community. Clinical Practice Group primary and multispecialty care clinics are located on the UNT Health campus in Fort Worth. Our care teams extend to local hospitals, surgery centers, long-term and continuing care centers, and mobile and in-home care. The Clinical Practice Group’s interprofessional teams work collaboratively to achieve an optimized treatment plan tailored to the individual patient. Physicians, nurse practitioners, physician assistants, physical therapists, pharmacists, social workers, psychologists, specialized technicians, and nurses work together while intentionally integrating health care students, residents, and fellows to deliver care to our community. This position is responsible for managing the coding team, coding training, provide audit reviews, and clinician documentation training. This role will help make the clinician practice more successful and make this easier for the clinicians and reduce audit risk.
Responsibilities
- Provides direct supervision over the coding staff to ensure the timeliness and accuracy of coding and data collection activities.
- Perform frequent audits to make sure everything is documented and billed correctly.
- Provide documentation trainings to clinicians to maximize on their billing efforts.
- Collaborate with other departments to ensure coding accuracy and resolve coding-related issues.
- Monitor coding productivity and quality, implementing process improvements as necessary.
- Strong knowledge of CPT and ICD-10 coding principles, governmental regulations, protocols, and Electronic Medical Records (EMR) system.
- Keeps abreast of changing industry and regulatory requirements and communicates changes to impacted clinicians, staff, and provides training.
- Oversees accurate billing of charges to Medicare, Medicaid, and other third-party payers according to insurance regulations and guidelines.
- Develops, implements and monitors policies and procedures, guidelines, and coding compliance plan for personnel in order to ensure compliance.
- Strong leadership, analytical, problem-solving, written, verbal, and interpersonal communication skills.
Requirements
Bachelor's degree and four (4) years related experience; or any equivalent combination of education and experience.
Qualifications
- 5+ years of professional coding experience with exposure to multiple specialties.
- Additional certification: Certified Professional Medical Auditor (CPMA) or Certified Documentation Expert Outpatient (CDEO).
- Nextgen Experience Required.
- License/Registration/Certifications: CPC.
Skills
- Knowledge of revenue cycle processes, including patient access, coding, claims creation, and filing procedures.
- Familiarity with insurance payer requirements, regulations, and compliance standards for provider billing.
- Understanding of financial management principles as they relate to optimizing cash flow and revenue cycle performance.
- Excellent communication skills to liaise with outside vendors, insurance representatives, and internal teams to resolve claims issues and improve processes.
- Proficiency in claims management software and financial reporting tools to track and analyze revenue cycle metrics.
- Ability to oversee and optimize revenue cycle processes to ensure maximum efficiency and financial performance.
- Strong problem-solving skills to address and resolve claims issues, denials, and billing discrepancies.
- Ability to maintain compliance with evolving regulations and payer requirements to minimize financial risk.