Coding Operations Manager

📋 Description

• Oversee all billing programs, systems, processes, and third-party vendors to ensure accurate, timely, and well-controlled operations related to coding departments.

• Compile weekly and monthly RCM reporting metrics to address any discrepancies outside established KPIs, including project status reports.

• Implement denial management strategies effectively by improving processes and collaborating directly or indirectly with internal teams and offices to enhance workflows and provide necessary training and education.

• Stay informed and communicate changes in coding guidelines across various markets.

• Meet regularly with Care Center Managers to ensure prompt resolution of care center hold items.

• Develop and enforce policies and procedures to optimize the billing workflow.

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

• Create a quality control program to align with the company’s quality initiatives.

• Monitor productivity goals and swiftly address any barriers to achieving these goals at both the individual and team levels.

• Provide counseling and disciplinary actions for employees in accordance with departmental goals and policies.

• Focus on developing and mentoring team leads and coding team members to promote internal growth.

• Ensure compliance with directives from all regulatory agencies and third-party entities.

• Facilitate team meetings aimed at fostering collaboration and process improvement.

⛳️ Requirements

• Bachelor’s Degree is highly preferred, though relevant experience may substitute for education.

• One or more applicable Coding Certificates (CPC, COC, CRC, CPMA, CGIC).

• Over 5 years of experience in healthcare billing.

• Experience working with a large, growing healthcare organization that supports 100 or more providers.

• Familiarity with HR policies, procedures, payroll, and timesheet management for staff.

• Extensive knowledge of patient registration, coding, billing, regulatory requirements, billing compliance, business operations, financial systems, and financial reporting.

🏝️ Benefits

• Competitive compensation.

• 401(k) retirement plans.

• Profit-sharing.

• Dental insurance.

• Health insurance.

• Life insurance.

• Paid time off.

• Vision insurance.

• Disability insurance.

• Pet insurance.

• Comprehensive benefits package including Cigna healthcare, dental, vision, life insurance, 401k, profit-sharing, short & long-term disability, HSA, FSA, and PTO plus 7 paid holidays.