Medical Coding Senior Manager

Job Description

• Orthopedic surgical coding experience required
• 5 of management experience required
• RPA experience strongly preferred
  
  

The Senior Manager of Coding, reporting to the Vice President of RCM, supports revenue cycle operations in accordance with established business objectives and applicable regulatory requirements. Responsible for directing and coordinating all Coding activities and claim submission. Ensures all KPIs related to net collections, gross days in AR, rejections and edits are met. Proactively manages Coding activities through monitoring key performance indicators and understanding the revenue cycle needs and financial performance targets. Recommends and implements process improvement strategies to further improve KPIs and financial targets.

TYPICAL DUTIES AND RESPONSIBILITIES:

• Responsible for leading, coaching, and mentoring direct reports, as well as overseeing and upholding performance standards and the level of accountability within the department.
• Promote growth of Team Members through established developmental goals, competencies, guidance, and counseling.
• Act as coach, leader, catalyst, and facilitator with Team Members; serve as a resource person for others.
• Provide direction to team members and organize the coding function to maximize departmental productivity.
• Direct and evaluate the activities of the Billing Leads to see that all their duties are carried out at a high level of efficiency and professionalism.
• Conduct regular productivity analysis and audits for assigned billing team.
• Manage department, including problem solving, administering procedures to increase efficiencies, and implementing new systems to ensure accountability.
• Lead compliance audit process.
• Performs proactive revenue analysis by tracking practice management activity against financial goals and key performance indicators (KPIs).
• Improves financial results by analyzing various factors, monitoring variances, identifying trends, and working with internal departments to resolve issues.
• Active participant to assist in efforts of all new acquisition onboarding
• Utilizes various software systems to generate reports, conduct data analysis, identify trends and variances, develop recommendations, implement solutions, and communicate all to VP of RCM
• Review, develop, implement, and maintain standard operating policies and procedures for the Billing Office that will facilitate the maintenance of internal and quality controls.
• Establish baselines and manage accounts receivable to ensure that they are kept at an acceptable level; interface with physicians to strive for continuous quality improvement in processes.
• Conduct and present appropriate statistical analyses and custom reports where needed. Implement new policies as necessary to improve performance.
• Provide leadership for the overall direction, coordination, implementation, execution, control and completion of specific projects ensuring consistency with organizational strategy, commitments and goals
• Work with the analytics team to identify meaningful metrics for deep dive RCM review.
• Work with IT to refine robotic process automation (RPA) workflow.
• Maintains and ensures compliance with regulatory standards. Abide by HIPPA standards and requirements.
  
  

Minimum Qualifications

Required Certifications, Registration or Licensure:

CPC

Minimum Knowledge and Education:

Bachelor’s degree preferred.

Minimum Work Experience:

10 years of central physician billing experience.

Specific Knowledge, Skills, Abilities:

• Minimum 10 years’ billing/revenue cycle management experience is required, with at least 5 years prior experience in a supervisory or management capacity.
• Knowledge of musculoskeletal specialties and ancillary services is required.
• Knowledge of RPA capability and workflow.
• Advanced knowledge of the healthcare industry and a sound financial background is required.
• Clear understanding of billing and collection regulatory guidelines and requirements.
• CPT and ICD-9/ICD-10 experience.
• Proficient background in reimbursements.
• Knowledge and experience in startup of a new or established revenue cycle engagements.
• High proficiency with computer software including but not limited to insurance websites, and Microsoft Office products to include Word, Excel, Outlook, and Teams. Competent with standard office equipment.
• Knowledge and experience in developing and manipulating excel reports/pivot tables.
• NextGen experience preferred.
  
  

Work requires the ability to recognize and process confidential and sensitive information appropriately.

Work requires the ability to communicate effectively both orally and in writing.

Work requires the analytical ability to gather, interpret and classify data.

Working Conditions:

Normal office environment.

Some travel may be required.

Company Description

Synergy Health Partners is a healthcare management organization at the forefront of patient care. We work with our physicians, nurses, and other clinical staff to maintain the highest quality of care centered on patient-focused outcomes. With respect for the person and their health as the driving mindset behind our practice, we aim to provide cutting-edge compassionate treatment to each and every one of our patients. We partner with healthcare practices large and small and use over forty years of experience in medicine in the Metro Detroit area to ensure peace of mind to all of those in our care.

Synergy Health Partners is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

Synergy Health Partners is a healthcare management organization at the forefront of patient care. We work with our physicians, nurses, and other clinical staff to maintain the highest quality of care centered on patient-focused outcomes. With respect for the person and their health as the driving mindset behind our practice, we aim to provide cutting-edge compassionate treatment to each and every one of our patients. We partner with healthcare practices large and small and use over forty years of experience in medicine in the Metro Detroit area to ensure peace of mind to all of those in our care. Synergy Health Partners is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.