Manager Professional Billing Coding Operations
New
B
Boston Medical CenterMedical coding
Source API remote eligibility restrictions: United StatesFull-TimeManager
Salary78,000 - 113,000 USD per year
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Job Details
- Experience
- Must have at least five years of experience in coding; experience must include education/mentoring/training. Minimum of five years acute care hospital experience coding with ICD-10-CM and CPT-4, academic medical setting or trauma center preferred. Minimum of three years management experience required; five years preferred.
- Required Skills
- HIPAA
Requirements
- Hold a bachelor’s degree or have an equivalent combination of formal education and experience.
- Hold CPC (Certified Professional Coder) certification.
- Have at least five years of coding experience, including education, mentoring, or training.
- Have at least five years of acute care hospital coding experience with ICD-10-CM and CPT-4; academic medical or trauma center experience is preferred.
- Have at least three years of management experience; five years is preferred.
- Have prior experience working with claim edits and denials.
- Demonstrate strong knowledge of ICD-10-CM, CPT-4/HCPCS, E&M coding, medical terminology, anatomy, physiology, and pathology.
- Know hospital inpatient and outpatient reimbursement methodologies, payer claim edits and denials, CMS National Coverage Determinations, and applicable coding regulations.
- Have experience with health records, computerized billing and charging systems, data integrity, and Microsoft applications.
- Be able to maintain confidentiality of personal and health-sensitive information and comply with HIPAA rules and regulations.
Responsibilities
- Manage the day-to-day operations of the professional billing coding team, including staffing, workload assignments, and performance evaluations.
- Develop, mentor, and train certified professional coders and provide coding education to healthcare professionals and revenue cycle staff.
- Review medical records and validate diagnoses, procedures, modifiers, and professional billing code assignments.
- Conduct chart audits and quality reviews to assess coding accuracy and compliance with coding guidelines.
- Review coding edits and denials, research issues, and identify trends and root causes.
- Initiate documentation queries and follow up on responses when records are incomplete or inconsistent.
- Monitor coding queues, productivity, and reporting on coding and abstracting accuracy.
- Track and respond to internal and external coding reviews, including RAC and payer reviews.
- Maintain coding updates and support coding-related education and operational improvements.
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