Coding Manager

Overview

As a Coding Manager, you will train to properly code claims to capture charges and correctly bill for services performed. Training and Revenue Integrity minimizes departmental rework, reprocessing of multiple claims from misaligned coding, and tracks and trends repeated missed opportunities for compliant charging and proactively finds and/or provides input regarding tools to streamline and/or improve charging processes. This position assists with maximizing revenue by identifying trends and remediate charge leakage or overage.

Responsibilities

• Analyze daily financial exceptions from the charge capture audit reports to determine areas of leakage and partner with information technology and clinical service lines to rectify charge capture issues by assisting service lines to improve their ability to capture compliant charges.
• Perform root cause analysis, when warranted by continuous trends when warranted by continuous trends, to pinpoint areas process gaps and continue to monitor and remediate any trends of charge leakage or overcharges
• Ability to track and report the percentage of generated revenue and overall improvement related to any new initiative.
• Supports Management by providing information, locating data resources and collecting data under tight time constraints.
• Provide analysis to monitor correct coding by the coding staff, and monitor coding related denials to identify trends and maximize facility reimbursement.
• Perform root cause analysis on coding related denials and provide recommended process improvements to reduce denials.
• Resolve complex patient and physician issues as necessary.
• Collaborates with internal departments to understand other system interfaces to ensure appropriate coding. Interface with operational and clinical leadership to assist in identification of operational and clinical best practices in maximizing revenue, understanding clinical suspects and monitoring of appropriate clinical documentation and quality coding. Assist with the creation of EMR forms to make sure documentation requirements are met for all services.
• Assist physicians and other clinic staff with coding and billing-related questions. Provide resources to educate and assist providers with AVP processes.
• Develop and present coding presentations and training to large and small groups of clinicians, practice managers and coders – developing training to fit specific needs.
• Supports management by providing information, locating data sources and collecting data under tight time constraints.
• Research, review and approve all SIM code changes, updates and additions within the established timeframes.
• Research new drugs, technology or procedures including but not limited to reimbursement for billing, EHR and claim requirements.
• Review and test any coding related changes to EHR or Autoflow.
• Review and follow up on coding IT Tickets within the established timeframes.
• Review, update and maintain system edits to ensure timely claims submission.
• Prioritize work to maximize turnaround times.
• Performs all other assigned duties.

Qualifications

• High School diploma or equivalent
• Certified Professional Coder (CPC) required
• 5 years of medical billing experience preferred
• Requires 3 or more years in a leadership role
• Previous experience providing coding education training, with preferred training to providers.
• Knowledge of electronic health record systems for applying codes and/or checking codes for accurate assignment based on provider documentation.
• Analytical skills necessary to dissect complicated issues and formulate creative solutions for problem solving.
• Strong background and experience in revenue cycle reimbursement.
• Active knowledge of CMS guidelines contracted insurance guidelines and coding policies.
• Demonstrated computer literacy including Microsoft Office applications.
• Well-organized with attention to detail.
• Ability to read and understand oral and written instructions.
• Ability to establish and maintain effective working relationship with team members, clinic staff, payers and patients.
• Have a desire and dedication to work with self-discipline.
• Maintains the strictest confidentiality: adheres to all HIPAA guidelines and regulations.

Benefits & Perks

Your health, happiness and your future matters! At AVP, we offer everything from medical and dental insurance, significant eye care discounts, child care assistance, pet insurance, continuing education funds, 401(k), paid holidays, PTO, Sick Time, opportunity for growth, and much more!