Director OF Medical Coding

Insight Global is seeking a Director of Medical Coding for a Primary Health Care client based in Atlanta. As the Director of Medical Coding Education, you'll be at the forefront of reviewing clinical data from various medical records and correctly assigning ICD-10-CM and / or CPT codes to patient records.

Your role will be vital in confirming accurate and compliant coding practices, using CMS's HCC methodology for risk adjustment.

You'll be instrumental in generating reports, supporting quality assurance measures, and offering training to providers and staff on risk adjustment and quality procedures.

Your guidance will be a vital asset to the team, and you will exemplify and uphold the highest standards of coding practices.

You will also manage the coding department & staff, achieve organizational and departmental coding / revenue goals, audit internal processes, and create effective SOPs.

• Lead Responsibilities : Be a primary authority on medical coding processes, and offer extensive technical training to junior members, ensuring a capable and adept coding team.
• Chart Reviews : Deeply review member charts at provider sites, identify the correct ICD-10-CM diagnosis codes, and input them accurately into the risk adjustment and quality process database.
• Accuracy and Compliance : Validate and uphold the precision, completeness, and correctness of diagnosis codes based on the documentation reviewed, conforming to CMS's HCC methodologies and ICD-10-CM Official Guidelines for Coding and Reporting.
• Provider Education : Scrutinize medical records and guide providers to ensure both documentation and coding meet the necessary standards, cultivating compliant coding culture.
• Audits and Quality Improvement : Execute a set number of audits in line with departmental aims, perform Quality Improvement and Education Reviews using audit tools as directed by the SVP, RCM.
• Provider Training : Create and offer provider educational resources and provide risk adjustment and quality process instruction to providers and staff, reinforcing their coding and compliance knowledge.
• Flexibility and Travel : Display adaptability in work hours and be ready to travel to external provider locations to support coding education projects.
• Additional Duties : Take on other related tasks assigned by management to benefit the coding education program.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day.

We are an equal opportunity / affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances.

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• Certification : Must possess Certified Professional Coder (CPC) or a similar medical coding certification.
• Experience : At least five years of medical coding experience with impeccable attention to detail.
• HCC Coding Experience : Three years in HCC coding or a Bachelor's in Health Information Management.
• Flexibility : Can adjust to varying work schedules and travel as required.
• Technical Skills : Mastery over Microsoft Office apps (Word, Excel, Outlook) for efficient data tasks.
24 days ago