Director, PB Coding Operations & Education

BMC Software

7d•$122,000 - $177,000

About The Position

The Director, PB Coding Operations & Education provides coding oversight and establishes standards to support coding accuracy, compliance, and appropriate reimbursement across BUMG. The role manages operational execution of these standards within areas reporting to Revenue Cycle and is responsible for coding operations and the effectiveness of the coding program, including oversight of coding training across BUMG. The Director manages coding staff to ensure compliance with coding guidelines and regulatory requirements and to support appropriate reimbursement for services rendered. The Director works with physicians, coders, practice staff, billing teams, leadership, and Compliance to promote accurate professional coding and clinical documentation, address coding and documentation concerns, and evaluate and improve processes. The position also oversees personnel management, staff development, and department productivity.

Requirements

Bachelor's degree or an equivalent combination of formal education and experience.
CPC – Certified Professional Coder certification.
At least 10 years of related professional coding experience with ICD-9/ICD-10, E/M, and CPT.
Previous management experience, including education, mentoring, and training.
Expert knowledge of ICD-9/ICD-10, CPT, and E/M coding principles and guidelines.
Knowledge of MS, AP, and APR DRG systems, APG, and EAPGs.
Knowledge of payer reimbursement methodologies and federal, state, and payer-specific regulations, policies, and compliance standards.
Excellent written, verbal, and communication skills.
Excellent critical-thinking skills.
Skill in providing hands-on education to providers, including communicating audit findings and improvement opportunities.
Strong organizational skills, including the ability to multitask, prioritize essential tasks, follow through, and meet timelines.
Ability to work cooperatively with healthcare delivery team members and staff.
Ability to adapt to changes in workload and priorities and respond quickly to urgent requests.
Ability to mentor, guide, and motivate direct reports by demonstrating best practices and leading by example.

Responsibilities

Provide coding oversight and standards that support accurate, compliant coding and appropriate reimbursement across BUMG.
Manage operational execution of coding standards in areas reporting to Revenue Cycle.
Oversee coding operations and the effectiveness of the coding program, including coding training across BUMG.
Facilitate accurate professional coding and clinical documentation through ongoing education for physicians, coders, and practice staff.
Direct coding activities to ensure accurate, consistent, and compliant coding for all services.
Ensure quality reviews are conducted to validate coding accuracy.
Participate in the rejections, denials, and claims review process with the billing team to support compliance and accurate reimbursement.
Identify trends in documentation and coding concerns and collaborate with Leadership and Compliance on corrective action.
Evaluate the success of coding processes on an ongoing basis.
Serve as the contact for professional coding across BUMG.
Work with Human Resources and department managers to select qualified candidates in accordance with policies, guidelines, and applicable laws.
Manage personnel effectively, including training, directing, and mentoring staff and promoting a commitment to quality and excellence.
Monitor department productivity and performance to identify strengths and training opportunities related to operational effectiveness.
Encourage staff development and pursue professional growth through educational programs, workshops, and maintaining knowledge of industry standards and practices.
Adhere to BMC's RESPECT behavioral standards.