The Coding Manager provides overall leadership in planning, organizing, and directing activities that support the coding operations of affiliated physician groups. Develops and monitors systems and processes to ensure the capture of charges. Identifies opportunities to enhance revenue through improved documentation and coding. Identifies physician education needs in coding and documentation and develops initiatives to address those needs. Contributes to organizational goal setting and the establishment of priorities. Fosters a collaborative team environment.
Clinical Quality Outcomes
- Establishes and maintains high standards for quality of care, & patient safety.
- Takes initiative to improve both processes and outcomes, incorporating best practices, and innovations in professional field.
- Ensures compliance with policies and all accreditation & regulatory bodies and their standards.
- Compellingly communicates to staff the critical role they play in achieving mission and strategic goals.
- Facilitates organizational change initiatives; leads and supports staff in adapting to a rapidly changing health care environment.
- Facilitates development and achievement of professional & personal goals for self and staff.
- Effectively recruits, orients, develops & retains a talented and diverse workforce.
- Strengthens our brand as a top tier provider and employer by establishing and maintaining high standards for excellence.
- Models our values of service, innovation and teamwork. Holds others accountable for living these values.
- Fulfills the Employee Promise by fostering a challenging & compassionate work environment, recognizing strong performance, and listening and acting on feedback
- Consistently models our Service Principles in internal and external interactions and ensures that the Service Principles are fulfilled to by others.
- Ensures employees receive information needed to perform jobs including feedback to enhance performance and customer satisfaction.
- Proactively addresses performance issues when indicated and administers policies, decisions, & disciplinary actions with consistency.
- Aligns department goals and manages department resources and budgets to meet strategic objectives.
- Helps others understand the drivers of financial success for the department and organization.
- Manages all Physician Billing Certified Coders. Ensures appropriate staffing for timely submission of professional bills.
- Collaborates with Management Team to establish priorities for coding operations. Directs development of work plans and strategies that address priorities.
- Develops, reviews and updates coding policies annually.
- Assesses physician educational needs of each specific division regarding documentation and coding. Collaborates with Audit Manager to determine priorities. Collaborates with audit manager in the development of effective regularly scheduled educational programs that meet physician needs. Provides regulatory updates to coders.
- Provides regularly scheduled feedback at division meetings regarding documentation and coding issues. Serves as primary resource to coders for documentation and coding issues.
- Collaborates with the Audit manager on the development and implementation of tools and templates to assist physicians with documentation guidelines.
- Serves as the physician billing representative on the HIM standards Committee. Serves on project teams as needed to properly represent physician billing. Effectively communicates findings to all relevant individuals.
- Performs regular coding audits of coding professionals on ICD-10 and CPT coding. Develops action plans as needed in response to audit trends.
- Implements CPT coding updates at least annually for fee schedule changes, template and superbill revision.
- Identifies opportunities to enhance revenue through improved documentation and appropriate coding.
- Mentors staff, providing performance feedback and opportunities for professional growth, training, and development, on an ongoing basis.
Knowledge, Skills and Abilities:
- Certification in one of the following: Certified as Professional Coder (CPC), Certified Coding Specialist – Physician (CCS-P), or Certified Professional Medical Auditor (CPMA) required.
- Minimum of five years’ experience in physician billing.
- Bachelor's degree preferred. RHIA or CPC required
- Minimum of three years of coding experience required.
- Prior experience in Evaluation and Management Coding preferred.
- Demonstrates thorough knowledge of CPT and ICD-9 coding by passing a test.
- Demonstrates thorough knowledge of Evaluation and Management (E/M) by passing a proficiency test; required.
- Ability to use computer software (i.e.: EPIC, WORD, EXCEL and PowerPoint).
- Demonstrated knowledge and understanding of medical terminology, anatomy and physiology and coding classification systems in determining appropriate physician coding.
- Ability to communicate effectively, work independently and balance multiple priorities.