Manager Coding

Allegheny Health Network Coding Manager

General Overview : Plans, directs, organizes, and controls the coding across multiple facilities to ensure timely coding for billing and coding compliance. This position is part of a leadership role in a high-profile team tasked with ensuring consistent and quality coding from discharge to final bill generation and resolution. The manager must maintain advanced knowledge of revenue cycle processes to aid in the implementation of regulatory standards that assist in coding while accurately complying with billing guidelines. This includes extensive knowledge of all aspects of the revenue cycle including the registration, coding, billing and collection processes as well as government and payor regulations for both professional and facility billing. The manager is responsible for the analysis and assessment of diverse data relating to the revenue cycle. Acting as an internal consultant, the manager provides essential quality reports, advice and improvement recommendations to management along all service lines. Manager is required to understand and communicate complex issues and changes relating to regulatory compliance to the department(s) involved, maintaining records of their notification, accountability and compliance. Works closely with hospitals and service line departments to provide accurate, critical information for identification of areas needing immediate attention to improve revenue results.

Essential Responsibilities :

• Manage, set vision, and define roles and responsibilities for coders, including training, delegating tasks, overseeing daily activities, mentoring, guiding through demonstration of best practices and offering opportunities for professional development. Ensures the highest standards for the hiring selection, training, orientation and assignments of department staff. Provides leadership to coders reporting to management staff with regards to the evaluation, promotion and resolution of employee relations / disciplinary concerns and the termination of employees, if necessary. (25%)
• Assures timely and accurate coding / abstracting to comply with regulatory agencies and fiscal intermediaries and meets turnaround time. Assures validation process required by external agencies. (20%)
• Facilitate the dissemination of information regarding government and payor regulations / requirements to clinical departments, providers, management and staff, as applicable. Oversees communication of coding updates to all stakeholders as appropriate. (20%)
• Assures that audited records are coded correctly, appealed if appropriate, follow-ups on process, and identifies education issues. Educates staff, registration and medical record staff regarding coding compliance and clinical documentation. (15%)
• Administers the computer system, and coordinates database requests for reports. (10%)
• Designs, implements and maintains quality control measures and productivity monitors. (5%)
• Performs other duties as assigned. (5%)

Qualifications :

Disclaimer : The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

Pay Range Minimum : $36.41 Pay Range Maximum : $57.36 Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org.