Coding Operations lead

Gastro Health•Miami, FL

3d•Onsite

About The Position

Gastro Health is seeking an enthusiastic full-time Coding Operations Manager to join their team. This role is responsible for the daily oversight and supervision of designated Coding Department teams, ensuring efficient workflows, compliance with coding guidelines, and achievement of key performance indicators (KPIs). Key duties include prioritizing workloads, supporting denial management efforts, and ensuring the team is highly effective for the providers. The position offers a great work/life balance, competitive compensation, and opportunities for internal advancement within a rapidly growing organization.

Requirements

More than 5 years’ experience/Seniority with healthcare billing
2 or more applicable Coding Certificates (CPC, COC, CRC, CPMA, CGIC) - Does not apply to data entry Lead
Experience with a large, growing healthcare organization supporting 100 or more providers and overseeing 10+ team members
Experience with a large Practice Management (PM) System, eCW (E Clinical Works) is a plus but not required
5+ years of experience in healthcare industry
1+ years of supervisory experience/leading a team, in Billing/Coding roles
Extensive knowledge of patient registration, coding guidelines, billing, regulatory requirements, billing compliance

Nice To Haves

Associates or Bachelor’s Degree is highly preferred but experience may be substituted for education

Responsibilities

Directly oversees and supervises day to day operations of designated Coding Department teams.
Prioritize, assess, and re-prioritize daily workflows to ensure timely execution of Coding and meeting/exceeding goals/KPI.
Assist with creation of front-end scrubs/edits based on coding guidelines and denial management review.
Effectively manages the team through streamlined improvement initiatives to ensure the team is highly effective for the providers.
Actively participates and maintain strong new hire training process and assist with policy/procedure documentation and process workflow.
Conduct audits of team members to ensure quality initiatives are being met and exceeded.
Identify and document trends in underpayments, denials, aging receivable that compromise the ability of the Coding team to meet established goals.
Assists with resolution of complex claims or projects and trains team to improve follow up efforts.
Prepare project data with external payors and partners.
Motivate, train, evaluate, record and report team members performance and progress.
Serve as a system matter expert of all Coding functions across the team to maintain a highly efficient and productive team and to ensure process can be trained effectively.
Assist Management in establishing weekly/monthly goals, ensure Coding team members are utilizing all resources and meeting and/or surpassing weekly/monthly KPI’s.
Assist manager with preparing weekly and monthly RCM reporting metrics to remediate any items outside established KPI including status report of projects.
Research and maintain understanding of policy changes across the RCM markets.
Daily reviews of incoming claim/denial volumes, daily billing, rejections, evaluate clean claim rates, and team workflows.
Assist manager in the interview process.
Assist with preparation of team meetings focused on collaboration and process improvement.
Assist Manager with employee performance appraisals and work with the coding team on skill development.
Run open claims reports in Visiquate for coder distribution.
Analyze productivity report to assure action plan and expectations are met by coding team.
Respond to RCM Care Center and Internal Request smartsheet.
Provide routing coder audit for quality assurance.
Utilize Visiquate, Power BI and reconciliation reports to upload and analyze data to align all Coding benchmarks and identify support areas and coverage.