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Lead Coding Operations Manager

2 months ago


San Diego, California, United States Ronin Staffing, LLC Full time

Position Overview:
Accountable for the creation, execution, and upkeep of a comprehensive quality management strategy across the organization, focusing on enhancing the overall quality, thoroughness, relevance, and precision of documentation and coding for professional services. Collaborates closely with senior leadership in the Revenue Cycle and evaluates coding and documentation practices by healthcare providers, delivering educational support throughout the organization.

Key Responsibilities:

  1. Direct system-wide initiatives for professional documentation and coding activities, including audits, training, and oversight.
  2. Drive workflow enhancements and standardization efforts to boost efficiency and accuracy in documentation and coding across all services and providers.
  3. Develop, implement, and sustain a structured review process for coding and documentation compliance, incorporating a formal audit mechanism and quality control framework.
  4. Communicate effectively with healthcare providers, articulating E&M levels based on documentation to both providers and billing staff.
  5. Supervise a team of coding professionals, ensuring efficiency and accuracy in coding while maintaining optimal billing timelines.
  6. Provide prompt feedback to providers and billing personnel, taking corrective measures to guarantee effective education.
  7. In partnership with the Billing Manager, periodically assess reimbursement patterns by CPT/ICD-10 codes to identify opportunities and address payment concerns, recommending necessary adjustments.
  8. Possess proficiency in ICD-10 and CPT coding, as well as E&M and all professional coding standards for large multi-specialty provider groups.
Additional Responsibilities:
  1. Remain updated with Official Coding and Reporting Guidelines, CMS, and other regulatory directives for ICD-10-CM/PCS and CPT coding. Engage in online education and attend mandatory coding workshops and seminars.
  2. Provide leadership, management, and oversight to ensure the effective operation of assigned departments.
  3. Foster effective communication and rapport with leadership, administration, and colleagues within the revenue cycle and other departments across the organization.
  4. Conduct weekly team meetings and monthly one-on-one sessions with direct reports.
Assist by supporting coders in managing work queues in Epic to ensure encounters are reviewed and processed efficiently.

Qualifications:
Education Required (Minimum level of education): Bachelor's Degree in Health Information Management, Healthcare Administration, Business Administration, or an equivalent combination of education and training.