Manager - Professional Clinical Coding

Full-time - Manager

Remote - Scarborough, ME

Ambulatory Health Care Services

About the position

The Manager of Professional Clinical Coding at MaineHealth Corporate is responsible for overseeing the Revenue Integrities Clinical Data Section. This role involves managing the coding and abstracting of medical records for outpatient practice clinic claims, preparing statistical analyses of medical records data, and ensuring compliance with regulatory requirements. The position plays a crucial role in financial and billing processes, including reimbursement determinations and maintaining acceptable accounts receivables.

Responsibilities

• Manage the coding and abstracting of medical records for outpatient practice clinic claims.
• Prepare statistical analysis of medical records data.
• Compile, analyze, and summarize data from medical records into various formats.
• Ensure compliance with internal and external regulatory agencies, including Quality Improvement Organizations and the Centers for Medicare & Medicaid Services.
• Direct concurrent and retrospective coding reviews and provide physician education.

Requirements

• Advanced education in Health Record Administration/ Technician /Science Bachelor's/Associate Degree program preferred.
• Certification in RHIA/RHIT, CCS, or CPC required.
• Minimum of two years prior successful supervisory experience required.
• Experience with EPIC, claim edit processes, encoder software, and CDI programs preferred.
• Full working knowledge of medical information and revenue cycle systems, medical terminology, anatomy, physiology, pathophysiology, microbiology, and pharmacology.

Nice-to-haves

• Knowledge of Provider Based Billing practices preferred.
• Experience with Grouper and Severity of Illness Systems preferred.

Benefits

• Paid parental leave
• Flexible work policy
• Student loan assistance
• Training and education
• Well-being resources for employees and their families