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Clinical Coding Manager

2 months ago

Boston, United States CRICO Full time
Job DescriptionJob Description

Role Summary:

  • Directs all coding activities and services for CRICO and CRICO Candello clients. Responsible for managing the Candello Clinical Coding Team and resourcing of coding services across all clients, ensuring client coding engagements are completed on time and with the highest level of efficiency and quality for all coded cases.
  • Provides leadership to the CRICO and CANDELLO client coders (Clinical Taxonomy Specialists), teaching, supporting, and reinforcing the CRICO coding methodologies and application guidelines.
  • Works with Candello leadership to establish and track progress toward business targets for production and revenue.

Key Duties & Accountabilities (% time spent):

  • Oversees all aspects of day-to-day management of the CRICO coding team.
  • Acts as client liaison for all new, ad hoc, and recurring client coding engagements.
  • Assigns / monitors progress of coding assignments ensuring efficient distribution of resources across clients to meet CRICO and contracted client needs, and Candello target margins for coding.
  • Monitors progress and communicates status to Candello client managers, participating in client update calls as determined by the client manager.
  • Responsible for the training of new staff and clients as required.
  • Collaborates with Taxonomy Managers on audits and coder feedback, evolving issues or concerns as they relate to the education and enhancement of the code sets and coding process.
  • Works with CRICO and client IT teams to support IT in security access for Candello coders.
  • Works with Candello business and operations leadership to plan, project and track expectations and progress toward client and corporate goals.
  • Collaborates on development and maintenance of reports that support assigning, tracking, and reporting out on coding services and progress e.g Client Status Metrics, CRICO Coding Team metrics, and Candello Coding Billing.
  • Collaborates on development of clinical coding application.
  • Leads efforts to enhance efficiencies in coding practice and recommends process improvements to coding workflow as appropriate.
  • Continually seeks to enhance coding materials to help clarify coding methodology and improve coding accuracy.
  • Drives the focus / development of coding education events including routine coding calls and the annual coders collaborative.
  • Support internal staff and clients in response to their information needs and requests regarding code usage.
  • Performs and/or coordinates other related duties as required by this position, including coding CRICO and client cases as needed to meet the resourcing and deadline needs.
  • Support and collaborate with Taxonomy Manager as needed.

Primary Contacts

Explaining or eliciting complicated or sensitive information with others outside of the department or with clients/members, requiring tact and diplomacy to ensure the correct message is delivered including contact with board and outside organizations. May include information with board and outside organizations.

Requirements

Minimum Requirements:

Knowledge, Education, Experience, & Skills:

  • Nursing degree required – Masters preferred.
  • 8-10+ years of clinical background in healthcare.
  • Management Experience
  • Advanced knowledge of medical terminology / coding tools e.g. ICD10.
  • Working Knowledge of healthcare organizations/providers with a specific focus on clinical risk management and patient safety, adverse event reporting, quality metrics and initiatives, regulatory requirements, and credentialing functions. Familiarity with claims management and litigation a plus.
  • Demonstrated ability to exercise judgment and independent thinking, remaining objective when applying clinical expertise to the error investigation and analysis of each case.
  • Basic user of standard business software (e.g. MS Office).