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Surgical Coding Manager

2 months ago

Jersey City, New Jersey, United States Summit Health Inc Full time
About Our Company

We are a leading healthcare organization committed to delivering high-quality, patient-centered care. Our mission is to simplify healthcare and bring a more connected kind of care to our patients.

Our organization is a physician-led network that serves millions of patients through our traditional practices, patients' homes, and virtually through our operating companies. We are innovating value-based care and leveraging integrated applications, population insights, and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care.

Job Description

The Coding Manager plays a critical role in managing the outsourced physician coding vendor(s), auditing their work, and ensuring that medical billing conforms to legal and procedural requirements.

Duties and Responsibilities:
  • Serve as the primary point of contact to coding vendors and physicians on documentation guidelines.
  • Create and enact policies related to our coding strategy.
  • Audit coding vendor work to ensure that appropriate levels of service, CPT-4 procedure codes, and ICD-10 diagnosis codes are assigned to claims.
  • Communicate with compliance officers, clinical staff/leadership, scribes, operations, and revenue cycle leadership to ensure adequate coding practices.
  • Leverage claims data to create/monitor benchmarks, evaluate coding vulnerabilities, and make recommendations on improvement.
  • Report on audit results and set corrective action plans.
  • Research, analyze, and respond to inquiries regarding compliance, inappropriate coding, denials, and billable services.
  • Stay up-to-date on current changes in coding and compliance requirements for government programs and other third-party payers.
  • Maintain high levels of compassion and professionalism while adhering to company policy and protocol.
Qualifications:
  • Bachelor's Degree Required (can include or equivalent coding experience).
  • Current CCS-P or CPC certificate required; and CPMA or other certifications preferred.
  • 3 to 5 years of experience in surgical coding.
  • EClinicalWorks knowledge a plus.
  • Expert knowledge of Surgical Coding and Evaluation and Management Coding (E/M) and familiarity with national Correct Coding Initiative (CCI) and Medicare Local Coverage Determination (LCD) guidelines.
  • Proven analytical and organizational abilities.
  • Proven ability to work with minimal supervision at a high level of productivity.
  • Must be able to communicate verbally and in writing in a high professional manner.
  • Time management skills should include ability to prioritize, organize under fast-paced and changing conditions to meet deadlines.
  • Detail-oriented.
  • Strong interpersonal skills and team-oriented perspective.
Physical Requirements:

This job may require, from time to time, repetitive tasks.

Pay Range: $85,000-100,000

The provided compensation range is based on industry standards and salary determinations will be made based on numerous factors including but not limited to years of experience and location of position.

About Our Commitment

We highly value the critical role that health and wellness play in the lives of our team members and their families. Participation in our benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages, and a 401k savings plan.

Equal Opportunity Employer

We provide equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and do not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.

Safety Disclaimer

We care about the safety of our employees and applicants. We do not use chat rooms for job searches or communications. We will never request personal information via informal chat platforms or unsecure email. We will never ask for money or an exchange of money, banking or other personal information prior to the in-person interview. Be aware of potential scams while job seeking. Interviews are conducted at select company locations during regular business hours only. For information on job scams, visit, or file a complaint.