Coding Manager

Duties/Responsibilities

• Manages the daily operations of the Hospital Coding Department to promote steady workflow and data integrity.
• Manages the daily operations of the Physician Practice Coding Department to promote steady workflow and data integrity.
• Collaborate with and educate physicians on coding and documentation guidelines.
• Research coding questions and provide coder feedback.
• Ensures timely correction of coding errors and edits.
• Ensures coding audits are performed concurrently and that the areas being audited are updated in conjunction with the department policies.
• Oversees the monitoring of the aging and DNB accounts to ensure that accounts are coded in a timely manner and that performance is within established coding quality and productivity benchmarks.
• Conducts regular audits and coordinates monitoring of coding accuracy, productivity, and available clinical documentation.
• Ensures that audit reports are reviewed, accurate, and corrective action plans implemented.
• Provides feedback and assists in facilitating and/or coordinating focused educational programs regarding coding and clinical documentation best practices to Coding and clinical staff as needed.
• Interviews, hires and trains employees; plans, assigns and direct workflow, appraises employee performance; addresses complaints and resolving problems; and proactively manages production and quality control efforts.
• Conducts trend analysis to identify patterns and variations in coding/documentation practices and case mix index.
• Identifies process improvement opportunities within the Coding department and implements solutions.
• Reviews claim denials and rejections pertaining to coding and medical necessity issues and implements corrective action plans as needed/required.
• Works to provide all Coding staff with annual, quarterly, semi-annual ICD-10-CM/PCS and/or CPT code changes.
• Maintains all coding information and provides updated manuals, resources, and other coding material.
• Maintain strong communication with Director(s) and business partners in reporting of unbilled activities related to coding.
• Mentors team members to encourage personal and professional growth.
• Encourages ongoing skill development by providing opportunities for continued education.
• Applies critical thinking, problem solving and change management skills to lead the process and team in identifying and resolving systemic issues.
• Develop, implement and monitor policies and procedures, guidelines, and coding compliance plan for coding.

Required Skills/Abilities

• Proven knowledge base in complete and accurate clinical documentation in all healthcare settings and for all healthcare disciplines.
• Demonstrated knowledge base and experience in acute care hospital and physician/clinic coding and billing practices.
• Demonstrated knowledge of the conventions, rules, and guidelines for multiple classification systems, including ICD-10 diagnosis and procedures, CPT and Evaluation & Management coding systems.
• Knowledge of multiple reimbursement systems (e.g., Medicare Severity-Diagnosis Related Groups (MS-DRG) and Ambulatory Payment Classification (APC).
• Knowledge of clinical documentation improvement methodologies.
• Ability to establish rapport with physicians and other healthcare practitioners.
• Must have strong analytical and critical thinking skills to support problem solving and associated change management.
• Prior use of 3M encoder and Epic software is preferred.

Education/Certification

• Associates degree in Health Information Management/Health Information Technology, or related healthcare field.
• OR 3 years of managerial experience in Health Information Management or Coding.
• Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician (CCS-P), or Certified Professional Coder (CPC).