Coding Operations Manager

Coding operations manager is responsible for overseeing the medical coding team and ensuring the accurate and efficient coding of patient records for billing, compliance, and reimbursement purposes. Oversee insurance verification department.  Needs skills with operational leadership, compliance oversight, team management, and process improvement within the healthcare revenue cycle.

Experience: Equivalent of an Associate’s degree and two to three years of relevant emergency department or general medical coding experience. CPC required, CEDC additionally preferred.  Strong expertise in all professional medical coding, including ICD-10, CPT and HCPCS coding.  Excellent organizational skills and ability to multi-task.

JOB RESPONSIBILITIES

• Oversee day-to-day operations of the medical coding team, ensuring timely and accurate coding and allocation of duties

• Ensure that all codes (ICD-10, CPT, HCPCS, etc.) are applied correctly and consistently according to official coding guidelines.

• Conduct regular internal/external audits to ensure compliance with federal regulations (e.g., CMS, HIPAA) and payer requirements address issues discovered

• Maintain knowledge of coding regulations, AMA/CMS guidelines and payer requirements.

• Research and Development of Compliance and Coding Standards 

• Assist in ensuring coding guidelines and processes for new clients adhere to all legal and regulatory requirements specific to the medical industry, creating a seamless integration for new contracts.

• Provide training for new hires and ongoing education for existing staff.

• Track coding productivity and quality metrics (e.g., charts coded per day, accuracy rates).
  Prepare reports regarding coding efficiency, denial trends, audit outcomes, etc.

• Identify trends, issues, or bottlenecks through performance data and propose process improvements.

• Work in collaboration with the RCM team to resolve any coding/insurance verification related issues by working closely with team members and other departments to implement solutions.

• Collaborate with physicians and APP’s  to clarify documentation and coding queries.  New physician and APP education.

• Work with the Operations Director to monitor the financial health of the company.