Client Coding and Operations Manager-Remote

Job Title: Client Coding and Operations Manager

The manager will have oversight of several client hospital overseeing production and quality of an offshore team. The manager will facilitate regular calls with the clients to ensure the offshore coding team is meeting their expectation. Client audit schedules need to be maintained and reviewed for accuracy. Serves as a knowledge expert and maintains up-to-date working knowledge of coding guidelines to act as a resource and point person for coders, auditors, and clients.

FLSA Status: Exempt

Classification: Full-Time

Reports To: The Client Coding and Operations Manager will report to [the Director of Coding].

Job Overview:

Responsibilities and Duties:

• Work with Revenue Cycle Management teams to identify claim denial patterns to understand root cause issues.
• Abide by the Standards of Ethical Coding as set forth by AHIMA and AAPC.
• Ensure optimal reimbursement of all cases in compliance with CMS policies and Official Coding guidelines.
• Monitor unbilled coding reports and ensure DNFB at client hospitals are within the expectation of the client.
• Perform preliminary and routine audits on coding staff for each client site and send results to leadership
• Ensure the SOPs are up to date
• Participate in coding education as needed
• Ensure all coding practices are compliant with all applicable rules and regulations
• Facilitate regular calls with clients
• Analyze and optimize coding processes to minimize errors and maximize clean claim rates
• Evaluate quality result to identify trends
• Develop metrics to monitor coding staff performance and report on results to leadership

Skills and Competencies:

• Ability to work well on a team and as an individual.
• Critical thinking skills, problem solving skills, follow-through skills, and the ability to see the “big picture.”
• Ability to read decipher and analyze all aspects of medical record documentation for inpatient and outpatient coding.
• Must possess a thorough knowledge of ICD-10 CM, PCS, CPT, modifiers, and DRG coding principles and applications as they related to professional fee and hospital coding.
• Excellent verbal and written communication skills
• Ability to work independently
• Advanced knowledge of CMS/MAC guidelines
• Provide excellent customer service

Requirements/Qualifications:

Some positions may require a certain level of education, related work experience, knowledge, skills, abilities, licensures, certification and/or other job-related requirements.

• Computer Assisted Coding (CAC) experience desired but not required.
• CPC or CCS-P required. CCS required (or obtained within one-year of employment[SF1] )
• Excellent verbal and written communication skills
• Intermediate skills in MS Office, particularly Excel or must pass Excel training Module within 90 days.
• Advanced knowledge of CMS/MAC guidelines
• Knowledge of various clinical information systems, encoders and electronic medical records
• Minimum of 3 years of inpatient and/or outpatient coding

Salary:

Competitive salary.

Benefits: Medical, Vision, Dental, 401k, PTO, etc Available

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.