Coding Manager - Hybrid/Durham

Operational Essential Duties and Responsibilities

• Ensure compliance to Coding standards as defined by the AMA through CPT, ICD, and HCPCS Government and Commercial Payer Contracts
• Accountable Care Organization (ACO) agreements
• Hold and attend regular meetings with coders, billing staff, providers, managers, and other stakeholders to share information and communicate on company issues, as needed
• Interview, hire, and provide orientation to coding staff
• Reporting including, but not limited to: Monthly status reports
• Insurance fee schedules
• Charge lag including claims awaiting provider completion and claims awaiting coding.
• Support Avance Care’s strategic execution of ACO agreements, as they relate
• HCC/RAF, CPT Category II coding, and other coding deliverables
• Compliance planning as it relates to government and private contracts, rules, and regulations, including execution of compliance policy and procedure at the coding level

Personnel Management

• Safeguard adherence to Avance Care Policies and Procedures
• Encourage employee behavior that represents the company in the best light
• Ensure standardized processes are executed efficiently
• Manage department workload and growth, including assignment of work and staffing plans
• Regularly review coding and documentation for accuracy and compliance
• Supervise all coding employees in order to:
  • Resolve issues outside the billing department, such as providers, operators, or regulators
  • Communicate effectively and politely with all staff members to minimize and eliminate employee dissatisfaction and conflicts
  • Address employee complaints in a timely manner
  • Interview, train, counsel, coach, discipline, and terminate employees, as necessary
  • Manage employee scheduling, vacation requests, and continuous shift coverage
  • Conduct staff meetings to share information and communicate on company issues
• Review, revise (as necessary), and maintain Operating Procedures and Training Manuals
• Notify the Vice President of RCM, Human Resources, and other managers of all non-routine matters relating to the operations and affairs of the areas for which the position is responsible, including but not limited to significant concern, current problems, and potential problems

Qualifications

• A bachelor’s degree in business administration, health administration or related field required, but MHA, or MBA highly preferred
• 6-8 years of office-based coding experience
• An active CPC Certification required (additional certifications such as CPME, CRC, CDEO preferred)
• Multispecialty, hospital, ambulatory, and/or surgical coding experience with knowledge of CPT, HCPCS, and ICD-10 coding desired

Skills

• Proficiency at writing reports, business correspondence, and procedure manuals
• Ability to work with mathematical concepts such as probability and statistical inference and apply to concepts such as fractions, percentages, ratios, and proportions to practical solutions
• Competent to make independent decisions and delegate responsibility and duties
• Proficient computer skills, including knowledge of EHR, Microsoft Office Suite, e-mail systems, and web-based programs
• Strong leadership qualities
• Knowledge and understanding of how for-profit medical practices run
• Working knowledge of accounting, including ledger, balance sheet, payroll, taxation, etc.

Benefits

Be part of a mission-driven organization that is changing the way healthcare is delivered across North Carolina. We offer a supportive, collaborative work environment where your leadership will make a measurable impact.

Avance Care provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to religion, race, creed, color, sex, sexual orientation, gender identity, alienage or citizenship status, national origin, age, marital status, pregnancy, disability, veteran or military status, predisposing genetic characteristics or any other characteristic protected by applicable federal, state or local law.