Coding Operations Lead

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

📋 Description

• Directly manages and supervises the daily operations of assigned Coding Department teams.

• Prioritize, evaluate, and adjust daily workflows to ensure timely completion of coding tasks while meeting or exceeding goals and KPIs.

• Aid in the development of front-end scrubs/edits based on coding standards and denial management reviews.

• Effectively lead the team through streamlined improvement initiatives to enhance efficiency for providers.

• Actively engage in and uphold a robust new hire training program, while assisting with policy/procedure documentation and process workflows.

• Conduct audits of team members to ensure that quality initiatives are achieved and surpassed.

• Identify and document trends in underpayments, denials, and aging receivables that hinder the Coding team's ability to reach established goals.

• Assist in resolving complex claims or projects and train the team to enhance follow-up efforts.

• Strong analytical skills are required to prepare project data for external payors and partners.

• Motivate, train, evaluate, and document team members' performance and progress.

• Serve as a system matter expert for all Coding functions within the team to maintain a highly efficient and productive environment, ensuring effective training processes.

• Support management in setting weekly and monthly goals, ensuring that Coding team members are utilizing all resources while meeting or exceeding their KPIs.

• Assist the manager in compiling weekly and monthly RCM reporting metrics to address any issues outside of established KPIs, including project status reports.

• Research and stay updated on policy changes in the RCM markets.

• Conduct daily reviews of various programs, including incoming claim/denial volumes, daily billing, rejections, clean claim rates, and team workflows.

• Aid the manager in the interview process.

• Help prepare team meetings focused on collaboration and process enhancement.

• Assist the manager with employee performance evaluations and work with the coding team on skills development.

⛳️ Requirements

• Over 5 years of experience/seniority in healthcare billing.

• Possession of at least 2 applicable Coding Certifications (CPC, COC, CRC, CPMA, CGIC) *Does not apply to data entry Lead*.

• Associate's or Bachelor's Degree is preferred, although experience may substitute for education.

• Experience with a large, expanding healthcare organization supporting 100 or more providers and overseeing a team of 10 or more members.

• Familiarity with a large Practice Management (PM) System; eCW (E Clinical Works) is a plus but not mandatory.

• Minimum of 5 years in the healthcare industry, including 1 year of supervisory experience in Billing/Coding roles.

• Ability to generate open claims reports in Visiquate for coder distribution, analyze productivity reports to ensure action plans and expectations are met by the coding team, and respond to RCM Care Center and Internal Request smartsheet. Provide routing coder audits for quality assurance.

• Utilize Visiquate, Power BI, and reconciliation reports to upload and analyze data to align with all Coding benchmarks, identifying areas needing support and coverage.

• Comprehensive knowledge of patient registration, coding guidelines, billing processes, regulatory requirements, and billing compliance.

🏝️ Benefits

• Health insurance

• 401(k) retirement plans

• Profit-Sharing

• Dental insurance

• Life insurance

• Vision insurance

• Disability insurance

• Pet insurance

• Paid time off

• 7 paid holidays