Director, PB Coding Operations – Education

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

📋 Description

• Provide oversight and establish standards for coding to ensure accuracy, compliance, and proper reimbursement throughout BUMG.

• Oversee the operational implementation of coding standards in areas under the Revenue Cycle.

• Manage coding operations and evaluate the effectiveness of the coding program.

• Direct coding training initiatives across BUMG.

• Supervise coding staff to guarantee adherence to coding guidelines, regulatory agency requirements, and appropriate reimbursement for services provided.

• Promote the accurate portrayal of professional coding and clinical documentation through continuous education for physicians, coders, and practice staff.

• Lead coding activities to ensure coding is accurate, consistent, and compliant for all services.

• Conduct quality reviews to verify coding accuracy.

• Engage in discussions regarding rejections, denials, and claims review with the billing team.

• Identify trends in documentation and coding, collaborating with Leadership and Compliance to implement corrective actions.

• Continuously assess the success of the coding process.

• Act as the primary contact for professional coding across BUMG.

• Collaborate with Human Resources and department managers to recruit qualified candidates.

• Manage personnel through training, guidance, mentoring, and promoting quality and excellence.

• Monitor departmental productivity and performance to identify strengths and training needs.

• Foster professional development through educational programs, workshops, and by staying current with industry knowledge.

⛳️ Requirements

• Bachelor’s degree or an equivalent combination of formal education and experience.

• CPC – Certified Professional Coder certification.

• At least 10 years of relevant experience in professional coding, including ICD-9/ICD-10, E/M, and CPT.

• Previous management experience is required, encompassing education, mentoring, and training.

• Proficiency in ICD-9/ICD-10, CPT, and E&M coding principles and guidelines.

• Familiarity with MS, AP, and APR DRG systems, as well as APG and EAPGs.

• Understanding of payer reimbursement methodologies, and regulations, policies, and compliance standards at federal, state, and payer-specific levels.

• Exceptional written, verbal, and communication abilities.

• Strong critical thinking skills.

• Proven ability to provide hands-on education to providers, including feedback on audit findings and improvement opportunities.

• Excellent organizational skills, with the capability to multitask, prioritize essential tasks, follow through, and meet deadlines.

• Ability to collaborate effectively with members of the healthcare delivery team and staff.

• Capacity to adapt to changes in workload and priorities, responding swiftly to urgent requests.

• Ability to mentor, guide, and inspire direct reports by demonstrating best practices and leading by example.

• Must comply with all of BMC’s RESPECT behavioral standards.

🏝️ Benefits

• Medical, dental, vision, and pharmacy benefits.

• Discretionary annual bonuses.

• Merit increases.

• Flexible Spending Accounts.

• 403(b) savings matches.

• Paid time off.

• Career advancement opportunities.

• Resources to support employee and family well-being.