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Coding Quality Manager

4 months ago

Tampa, United States Insight Global Full time

Insight Global is hiring a permanent placement position, Manager of Coding Quality, for one of our large healthcare insurance clients.

The role is currently Hybrid with 2 days in office. This function provides coding and coding auditing services directly to providers. Will be a hands on, working manager role with a team of 9 direct reports; 8 coders and 1 Billing manager. With the billing team reporting into this position, it is crucial this manager understands physician billing and its impacts to coding. This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes. Demonstrates experience by correlating coding accuracy with correct HCC assignment for MA/Risk and/or CPT, ICD-10, HCPCS and Modifiers for FFS. Complies with all aspects of Coding and Corporate Compliance standards. Abides by all ethical standards and adheres to official coding guidelines.

Must Have Requirements:

  • Active CPC required
  • Minimum 5 years of Medical coding experience for a providers office or health insurance company
  • 3+ years of management/supervisor Coding experience
  • Has managed 10+ direct reports
  • Proven success leading a team in a production based environment
  • HEDIS, primary care or HCC coding background preferred
  • Comfortable in a hands on role that includes training coding team, and coding themselves as needed
  • Strong understanding of physician billing – understands how submitting bills to insurance effects coding