Coding Manager

ESSENTIAL FUNCTION

Essential functions are those tasks, duties and responsibilities that compromise the means of accomplishing the job's purpose and objectives.  Essential functions are critical or fundamental to the performance of the job.  They are the major functions for which the person in the job is held accountable.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Development of the Billing Office Department

• Works collaboratively with the Vice President, Revenue Cycle on Key Performance Indicators (KPI’s) and effectiveness of the revenue cycle team.

• Manages all coding functions ensuring all claims are coded and billed accurately, in complete compliance with regulatory and company requirements, and in a timely manner. Ensures accurate reimbursement is being received for services rendered.

• Manages the daily activities of the business office including front end coding, billing, claims review, denial management and payments.

• Active knowledge of CMS guidelines, contracted insurance guidelines, and coding policies. 

• Oversees and Manages the work of billing office staff and encourages the ongoing development of the coding team.
• Responds to providers/staff requests accurately and in a timely fashion.
• Participates in management staff meetings and attends other meetings and seminars as needed or required.
• Works daily with the Vice President, Revenue Cycle to define daily revenue expectations, discuss opportunities and resolve challenges.

Electronic Healthcare System

• Maintains a strong working knowledge of the systems used and is prepared to provide support to staff and management when requested.
• serve as a resource for the revenue cycle team and practice leadership by assisting  them with the analysis of current performance through data.  Support and help with interpreting the data to identify process improvement that support revenue cycle services.
• Remains current on the specific data requirements as dictated by various government and private insurance carriers and ensures the system(s) are appropriately updated.
• Analyze, review and develop reports necessary for the billing office to ensure IMS goals and guidelines are achieved.

Training and Development

• Be hands-on in supporting the team with daily tasks.
• Encourages and assists with the ongoing development and education of staff.
• Defines billing office training programs by adequately supplying identifying and developing the resources required to achieve the IMS goals and expectations of billing and coding operations.
• Responsible for managing the on-going, users training for new hires and existing coding staff in the business office to ensure the systems are utilized to their fullest capabilities.
• Provide continuing education regarding insurance carriers changes and updates.

Employee Relations

• Partner with Vice President, Revenue Cycle on policies and procedures throughout the billing operation to standardize operations, communicate expectations, and establish agreed upon outcomes.
• Partners with management to communicate policies, procedures, and programs that impact the practices within IMS.
• Supervise the performance and provide evaluation of the Revenue Cycle operations team and business office
• Promotes the IMS accepted employee relations practices necessary to establish a positive employer-employee relationship and promote a high level of employee morale and motivation.
• Works with Human Resources to conduct investigations when employee complaints or concerns are brought forth.
• Monitors the implementation of a performance improvement process with non-performing employees.
• Manages, trains, orients and evaluates performance of assigned personnel. Recommends merit increases, promotions, and disciplinary actions.
• Performs regular, routine audits and quality checks.
• Fosters relationships internally and externally, to include but not limited to, practices, IMS departments, vendors, and insurance carriers.

Organization Development

• Leads the development of departmental goals and metrics for the coding team to include but not limited to charge entry lag, days missing slips, back-end denial rate, days in AR, Collection ratio, accepted timeframe of charge entry and payment posting.
• Trend and analyze denials and back-end failed claims for training and development of the coding and revenue cycle team.
• Manages employee communication and feedback through such avenues as office/ departmental meetings, memos, and one-on-one meetings.
• Monitors revenue cycle worklists and buckets within the EHR and delegates accordingly.
• Mentor and monitor the volume of employees work in all departments of the central billing office.
• Maintains an understanding of front office processes and procedures for improvement initiatives as it applies to revenue cycle workflows.
• Conducts quarterly quality and productivity audits with feedback to the entire coding team.
• Performs proactive audits upon request from providers within IMS.
• Ensures an annual audit rotation of all providers and staff are completed to ensure accurate and timely coding and billing activities.

NON ESSENTIAL FUNCTIONS

•  Must have experience reading and understanding payer remittance advices. Includes the ability to differentiate between allowed charges, contractual adjustments, line-item denials/reasons, patient responsibility (co-pa, co-insurance, and deductibles), bundled payment, etc.

• Utilizing MS-Excel for analyzing data using basic formulas, pivot tables, and charts.

• Creates reports and accurately presents them.
• Recognizes possible solutions to problems and is able to explain issues and propose solutions.
• Maintains customer confidence and protects operations by keeping information confidential.
• Contributes to team effort by accomplishing related results as needed.
• Manages multiple projects and deadlines.
• Performs all other duties as assigned.

MINIMUM REQUIREMENTS

• Certified Professional Coder (CPC) certification required.
• 3-5 years’ experience required, specifically overall coding management of a large (50-100 providers) medical group practice with knowledge of physician billing and coding with insurance claim follow-up and denial management preferred.
• 3-5 years minimum of direct coding management experience of a team is required.
• Knowledge of medical terminology and coding language.
• Financial management, including the ability to analyze data for operations, budgeting, auditing, and forecasting.
• Basic accounting knowledge including A/R analysis, staffing and financial reporting skills.
• Excellent interpersonal skills, with a demonstrated ability to work with a wide variety of people, both within the system and outside.
• The ability to plan, organize and effectively lead multi-disciplinary teams and projects and develop meaningful results within established timeframes.
• .Working knowledge of electronic billing systems and strong working knowledge of governmental billing requirements and resources.
• Demonstrated experience in implementing electronic healthcare systems.
• Exceptional verbal and written communication skills in relaying technical information to non-technical advisers.
• Demonstrated ability to serve as a successful participant on a management team that provides company leadership and direction.
• Demonstrated ability to interact effectively with peers and subordinates.
• Excellent computer skills in a Microsoft Windows environment.
• Demonstrates attitude of accessibility and availability.
• General knowledge of various employment laws and practices.
• Evidence of the practice of a high level of confidentiality.
• Excellent organizational and record keeping skills.
• The ability to work in a constant state of alertness and in a safe manner.

Joining Integrated Medical Services is more than saying “yes” to making the world a healthier place. It’s discovering a career that’s challenging, supportive and inspiring. Where a culture driven by excellence helps you not only meet your goals, but also create new ones. We focus on creating a diverse and inclusive culture, encouraging individual expression in the workplace and thrive on the innovative ideas this generates.  Our hope is that each day you’ll uncover a new reason to love what you do. If this sounds like the workplace for you, apply now! 

You can look forward to a generous compensation package including medical, dental, vision, short-term and long-term disability, life insurance, paid time off and a very lucrative 401K plan. 

*IMS is a tobacco-free work environment 

IMS is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sex, disability status, sexual orientation, gender identity, age, protected veteran status or any other characteristic protected by law. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.