Coding Manager

This is a fully remote position, open to applicants in New Jersey.

📋 Description

• Oversee daily coding operations for professional fee claims across various clinical specialties.

• Track workflow and ensure adherence to standard operating procedures.

• Offer hands-on assistance for intricate coding reviews and escalated coding challenges.

• Assess program performance and formulate corrective actions and improvement strategies.

• Recognize opportunities to enhance coding accuracy, reimbursement, productivity, quality, and financial outcomes.

• Provide expert knowledge in professional fee coding and billing.

• Analyze coding and billing workflows to identify operational deficiencies.

• Review trends in coding accuracy, productivity, quality, reimbursement, and compliance.

• Evaluate the interplay between documentation, coding, billing, reimbursement, and denials.

• Identify strategies to minimize coding-related denials and avert revenue losses.

• Assess charge capture, claim submission, edits, billing workflows, and payer demands.

• Collaborate with CDI, coding, utilization review, denials, and revenue cycle teams.

• Act as a client-facing leader for professional fee coding operations.

• Facilitate meetings with coders and clients.

• Formulate recommendations based on client data, workflows, financial results, and operational insights.

• Build relationships with coding leaders, providers, and stakeholders.

• Manage client escalations and ensure prompt resolution.

• Identify ways to deepen existing client relationships through additional offerings.

• Support efforts to enhance clean claim rates, decrease denials, speed up reimbursement, and boost net revenue.

• Collaborate with clients to set benchmarks and improvement objectives.

• Develop and analyze dashboards and performance reports.

• Establish program baselines and measurable improvement goals.

• Analyze productivity, quality, denial, reimbursement, and financial data.

• Work with analytics resources to generate client reports.

• Participate in the rollout of new coding, billing, and revenue cycle initiatives.

• Ensure that coding and billing practices comply with federal and state regulations, payer requirements, and client policies.

• Oversee coding quality and compliance.

• Support internal and external audits.

• Identify compliance risks and propose corrective measures.

• Maintain proper documentation and audit trails.

• Set performance expectations and foster accountability.

• Advocate for quality, accountability, continuous improvement, and exceptional client service.

⛳️ Requirements

• Bachelor’s degree in health information management, Healthcare Administration, Business, Finance, or a related discipline; equivalent experience may be considered.

• Over 7 years of progressive experience in professional fee coding, billing, HIM, revenue cycle, or healthcare financial operations.

• Must possess coding credentials with at least one of the following certifications: RHIA, RHIT, CPC, CCS, or CCS-P.

• At least 2 years of leadership or supervisory experience.

• Strong grasp of professional fee billing and revenue cycle operations.

• Experience working with healthcare clients, hospitals, health systems, or physician organizations.

• Solid understanding of payer requirements and reimbursement methodologies.

• Exceptional written, verbal, presentation, and communication abilities.

• Familiarity with Epic or other major EHR platforms.

• Proficient in encoder, CAC, CDI, billing, or revenue cycle technologies.

• Knowledge of hospital denials and appeals processes.

• Experience in revenue integrity.

• Background in working with outsourced coding or revenue cycle organizations.

• Experience managing multi-client or national healthcare programs.

• Willingness to travel as required.

🏝️ Benefits

• Remote work arrangement

• Full-time employment