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Coding Compliance and Education Manager
2 months ago
Position Overview:
The Coding Compliance and Education Manager plays a pivotal role in overseeing the management, assessment, and enhancement of operations associated with coding education, audits, and denial management.
Key Responsibilities:
- Leadership: Directs the Coding and Auditing team tasked with assessing the validity and medical necessity of billed services and procedures based on supporting documentation, including the appropriate application of ICD-10, HCPCS, and CPT codes.
- Audit Oversight: Manages routine retrospective and prospective audits for both professional and technical billing, ensuring compliance with established standards.
- Training Development: Collaborates in the creation of training materials for coders, healthcare providers, and clinical documentation specialists, ensuring all staff are well-versed in coding principles.
- Denial Management: Analyzes coding-related denials and leads initiatives to address and learn from these trends.
- Performance Metrics: Establishes Key Performance Indicators (KPIs) and evaluates metrics to assess the effectiveness of training programs.
Qualifications:
- Education: Associate's Degree or equivalent experience in coding audit and education.
- Experience: Minimum of 4 years in hospital auditing and coding, with pediatric experience preferred.
- Skills: In-depth knowledge of coding processes, proficiency in Microsoft Office, and excellent communication skills with healthcare professionals.
- Certifications: CPC, CPC-H, CCS-P, or CCS certification is required.
Organizational Accountabilities:
Demonstrates commitment to organizational values through teamwork, communication, and continuous improvement in performance and safety standards.
Work Environment:
Children's National Health System is dedicated to maintaining a professional and supportive workplace that promotes the well-being of its employees and the communities it serves.
