Medical Coding Manager
Job Description
GENERAL
Summary:
Under the direct supervision of the Coding & Records Manager, the Certified Coder is responsible for improving collectable revenue through accurate coding, ensuring compliance of coding usage and documentation, and maintaining adequate education.
ESSENTIAL JOB FUNCTIONS:
Daily coding of physician office and hospital charges, mid-level office charges, labs, x-rays and review of claim denials utilizing current CPT, ICD-9/ICD-10, HCPCS, CMS, and insurance guidelines.
Efficiently communicate with the managers, providers, and staff by accurately answering questions, reporting incorrect coding trends, training, and clarifying documentation.
Update and maintain fee tickets as necessary to facilitate accurate coding.
Coordinate with the Coding & Records Manager, Senior Business Services Manager, and Compliance to maintain the fee schedule at a level appropriate to maximize reimbursement.
Conduct quality assurance studies by performing random chart audits to determine usage, compliance, accuracy of codes and medical record completeness with direct accuracy, monitoring date of service vs. posting dates vs. dates of payment, verifying ordered services vs. billed services, identifying and correcting coding problems, and identifying potential income loss.
Maintain the Ingenix Claims Manager System, process daily edits, identify coding edits, and identify need of possible new edits to Manager and Senior Business Services Manager.
Attend monthly coding meetings.
Develop and provide specialized coding training with providers and staff.
Maintain and increase coding skills by attending AAPC meetings, reading all appropriate newsletters and updates, and participating in on-line training as directed by the Coding & Records Manager.
Perform coding research and provide training of information learned to physicians and the coding department.
Obtain a CPC certification within six months of hire date and maintain the CPC Certification throughout the duration of employment.
Over time, including but not limited to evenings and weekends, may be required.
Qualifications:
EDUCATION: High School Diploma or general education degree (GED). Must also be certified as a CPC, CCS-P, or RHIT. RHIT with 1 year physician coding application.
LANGUAGE SKILLS: Able to read, analyze, and interpret general business periodicals, professional journals, technical procedures, and governmental regulations. Proficient in writing reports and business correspondence, effectively presenting information, and responding to questions from groups of managers, clients, customers, and the general public.
Mathematical skills: Able to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Also able to compute rate, ratio, and percent to draw and interpret bar graphs.
Reasoning Skills: Able to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exist. Also able to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Effectively manage multiple tasks simultaneously.
DISCLAIMER CLAUSE:
The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job. It is intended to be an accurate reflection of the general nature and intensity of the job.Estimated Salary: $20 to $28 per hour based on qualifications.
GENERAL
Summary:
Under the direct supervision of the Coding & Records Manager, the Certified Coder is responsible for improving collectable revenue through accurate coding, ensuring compliance of coding usage and documentation, and maintaining adequate education.
ESSENTIAL JOB FUNCTIONS:
Daily coding of physician office and hospital charges, mid-level office charges, labs, x-rays and review of claim denials utilizing current CPT, ICD-9/ICD-10, HCPCS, CMS, and insurance guidelines.
Efficiently communicate with the managers, providers, and staff by accurately answering questions, reporting incorrect coding trends, training, and clarifying documentation.
Update and maintain fee tickets as necessary to facilitate accurate coding.
Coordinate with the Coding & Records Manager, Senior Business Services Manager, and Compliance to maintain the fee schedule at a level appropriate to maximize reimbursement.
Conduct quality assurance studies by performing random chart audits to determine usage, compliance, accuracy of codes and medical record completeness with direct accuracy, monitoring date of service vs. posting dates vs. dates of payment, verifying ordered services vs. billed services, identifying and correcting coding problems, and identifying potential income loss.
Maintain the Ingenix Claims Manager System, process daily edits, identify coding edits, and identify need of possible new edits to Manager and Senior Business Services Manager.
Attend monthly coding meetings.
Develop and provide specialized coding training with providers and staff.
Maintain and increase coding skills by attending AAPC meetings, reading all appropriate newsletters and updates, and participating in on-line training as directed by the Coding & Records Manager.
Perform coding research and provide training of information learned to physicians and the coding department.
Obtain a CPC certification within six months of hire date and maintain the CPC Certification throughout the duration of employment.
Over time, including but not limited to evenings and weekends, may be required.
Qualifications:
EDUCATION: High School Diploma or general education degree (GED). Must also be certified as a CPC, CCS-P, or RHIT. RHIT with 1 year physician coding application.
LANGUAGE SKILLS: Able to read, analyze, and interpret general business periodicals, professional journals, technical procedures, and governmental regulations. Proficient in writing reports and business correspondence, effectively presenting information, and responding to questions from groups of managers, clients, customers, and the general public.
Mathematical skills: Able to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Also able to compute rate, ratio, and percent to draw and interpret bar graphs.
Reasoning Skills: Able to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exist. Also able to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Effectively manage multiple tasks simultaneously.
DISCLAIMER CLAUSE:
The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job. It is intended to be an accurate reflection of the general nature and intensity of the job.Estimated Salary: $20 to $28 per hour based on qualifications.
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