The Coding Manager will have direct oversight and responsibility of all coding activities. This position manages and oversees daily coding operations and requires expertise in CPT, HCPCS, and ICD-10 guidelines for orthopedics and ambulatory surgery centers. The Coding Manager will have responsibility to oversee all coding activities in compliance with applicable laws, regulations, standards, internal policies and procedures and the Code of Business Conduct and Ethics (“Code of Conduct”). The Coding Manager works collaboratively with members of other departments and leadership to ensure organizational goals are met.
RESPONSIBILITIES
- Oversight of coding specialists.
- Assigns CPT, HCPCS, and ICD-10 guidelines in accordance with authoritative coding standards and guidelines.
- Review and resolve coding denials.
- Implement policies and procedures to promote accurate and compliant coding and reduce coding denials.
- Monitor and update payer specific coding and coverage guidelines.
- Conduct routine monitoring of provider and coding specialist coding accuracy.
- Develop and deliver coding education and training to applicable stakeholders.
- Oversight of coding vendors.
- Conduct research of authoritative coding policies and guidelines and provides guidance in response to coding questions from stakeholders.
- Collaborate with other departments and senior leadership to ensure ongoing alignment of priorities and drives measurable improvement in coding accuracy.
- Ensure proper reporting of violations or potential violations to Compliance and Leadership.
- Maintain current knowledge of applicable coding guidance, policies laws, and regulations.
COMPETENCIES
- Thorough knowledge of musculoskeletal anatomy, disease processes and diagnostic/surgical procedures.
- Thorough knowledge of CPT, HCPCS, and ICD-10-CM coding principles, rules and reimbursement structures.
- Demonstrated leadership skills.
- Excellent oral and written communication skills and excellent time management abilities.
- Ability to independently manage and set priorities in a fast-paced environment often with competing demands on time.
- Ability to prioritizes multiple, ongoing initiatives and efficiently re-prioritizes such responsibilities, as may be required in a changing business environment.
- Ability to analyze and interpret complex data.
- Demonstrates initiative, exercises good judgment, and possesses the ability to achieve results through others.
- Is an intelligent, articulate, and persuasive leader who can serve as an effective member of the senior leadership team in a highly dynamic work environment.
- Is comfortable interacting with all levels of employees.
- Has strong research skills and a desire to continue learning.
- Has the ability to rapidly expand subject matter knowledge base.
- Demonstrates the ability to work with sensitive information and maintain confidentiality.
- Values and respects the diverse contributions by other members of the company.