Manager Professional Billing Coding Operations - Remote

BMC Software

2d•$78,000 - $113,000•Remote

About The Position

The Manager Professional Billing Coding Operations is responsible for the day-to-day management of Boston Medical Center’s BUMG Professional Billing Coding Operations team. The role supervises, develops, and mentors certified professional coders; oversees coding accuracy, productivity, staffing, quality reviews, coding edits, denials, and coding-related external reviews; and supports professional claim coding. The manager works with the Director of PB Coding Operations and partners with coding education and revenue cycle stakeholders to identify coding trends, resolve denials, improve documentation and coding practices, and provide education to staff and providers. The position reviews medical records and coding work to ensure accurate assignment and sequencing of diagnoses, procedures, and modifiers under ICD-10-CM, CPT-4, and HCPCS. It applies official coding rules, regulatory and payer guidelines, and applicable reimbursement requirements; evaluates documentation and initiates queries when needed. The manager reports coding accuracy and abstracting results, conducts audits and benchmarking analyses, and develops strategies to improve team efficiency and productivity. The role also manages personnel activities, including hiring, orientation, training, evaluations, discipline, workload and schedule assignments, and timekeeping approvals. It maintains current coding knowledge and credentials, supports coding education and updates, and ensures confidentiality, HIPAA compliance, and adherence to hospital safety and infection-control procedures. The position is remote, full-time, and offers a stated compensation range of $78,000 to $113,000, with total compensation that may include benefits and other offerings.

Requirements

Bachelor’s degree or an equivalent combination of formal education and experience.
Certified Professional Coder (CPC) certification.
At least five years of coding experience, including education, mentoring, or training.
At least five years of acute-care hospital coding experience using ICD-10-CM and CPT-4.
At least three years of management experience.
Prior experience working with claim edits and denials.
Excellent command of ICD-10-CM and CPT-4/HCPCS coding conventions, including E&M coding.
Knowledge of human anatomy, physiology, pathology, medical terminology, health records, and inpatient and outpatient reimbursement methodologies.
Knowledge of computerized billing and charging systems, computer systems, Microsoft applications, data integrity, and processing techniques.
Knowledge of payer claim edits and denials, CMS National Coverage Determinations, and applicable coding regulations and laws.
Ability to provide hands-on education to coding staff based on audit findings and identified needs.
Ability to mentor, guide, and motivate direct reports by demonstrating best practices and leading by example.
Strong organization, prioritization, multitasking, follow-through, and time-management skills.
Accuracy and attention to detail; ability to solve problems using job knowledge and current policies and procedures.
Ability to work cooperatively with healthcare delivery teams and staff, handle frequent interruptions, adapt to changes in workload and schedule, and respond quickly to urgent requests.
Ability to maintain strict confidentiality of personal and health-sensitive information and ensure HIPAA compliance.

Nice To Haves

Experience in an academic medical setting or trauma center.
Five years of management experience preferred.

Responsibilities

Manage the day-to-day operations of the Professional Billing Coding Operations team under the direction of the Director, PB Coding Operations.
Manage, develop, mentor, interview, hire, orient, train, evaluate, discipline, and, when necessary, terminate coding personnel.
Set staffing schedules and assign workloads and projects in response to changes in volume.
Review medical records and code diagnoses, procedures, and modifiers using ICD-10-CM, CPT-4, and HCPCS classification systems.
Sequence diagnoses, procedures, and complications according to applicable official, regulatory, and payer guidelines; consult medical staff to clarify documentation when needed.
Monitor coding queues and productivity, and maintain departmental productivity standards.
Review and respond to coding questions and serve as a contact for coders regarding missing or incomplete information.
Ensure billed services are accurately coded and conduct random chart audits and quality reviews to validate code selection and compliance.
Evaluate records for incomplete or inconsistent documentation, initiate queries when necessary, and monitor responses.
Analyze coding benchmarks and report on coding and abstracting accuracy.
Oversee coding edits, denials, and responses to coding accountabilities from internal and external sources, including RAC and payer reviews.
Provide coding updates, in-service training, and hands-on education to coding staff and other healthcare and revenue cycle personnel.
Partner with the Coding Education Team to identify trends and develop coding, clinical documentation, audit, and education programs for providers and staff.
Develop long-term strategies to improve coding efficiency and team productivity through consistent coding practices, systems, and education.
Track staff overtime, absenteeism, hours, leave, and vacation or sick time; review and approve timesheets for Payroll.
Maintain coding knowledge and credentials through continuing education, conferences, workshops, literature, and other programs; share learning with staff.
Participate in coding and reimbursement meetings.
Follow hospital infection-control and safety procedures and maintain confidentiality and HIPAA compliance.
Perform other duties as needed or required.