Senior Manager of Medical Coding & Reimbursement (4257) CORP OFF

Lexington Clinic•Lexington, KY

1d•Onsite

About The Position

The Sr. Manager of Medical Coding and Reimbursement manages and directs the daily functions of the Reimbursement/Coding Analysts and Lead, the Reimbursement Manager, the Internal Documentation Auditor and the Reimbursement Specialist. This role ensures prompt and accurate charge capture, coding and charge entry, including the accuracy of the various charge entry interfaces and the Athena Billing Tab results. The position oversees/manages various payor billing audits, interprets and applies both internal and external policies and procedures, and develops and implements new procedures as necessary. The Sr. Manager establishes, implements, and monitors Quality Control Procedures, provides continuing education regarding correct coding and documentation, and denial patterns to operations staff, managers and providers. This role maintains and distributes up-to-date coding information and routinely investigates the impact of coding on insurance reimbursement and designs effective, accurate and efficient coding workflows to facilitate compliant billing and optimal revenue.

Requirements

Formal training to be indicated by a high school diploma or equivalent.
Minimum two years coding and/or reimbursement activities.
Two years supervisory experience.
Knowledge of third party fee profiles and reimbursement mechanisms.
Completion of course in medical record terminology.
Certification as a Certified Professional Coder, or equivalent certification.
Excellent judgment, communication and interpersonal skills.
Planning, implementing, controlling and evaluation skills.
Flexibility in problem solving and developing programs.

Nice To Haves

College degree
Proven experience directing multi-specialty coding functions for a large group practice.

Responsibilities

Manages and directs the daily functions of the Reimbursement/Coding Analysts and Lead, the Reimbursement Manager, the Internal Documentation Auditor and the Reimbursement Specialist.
Ensures prompt and accurate charge capture, coding and charge entry, including the accuracy of the various charge entry interfaces and the Athena Billing Tab results.
Oversees/manages various payor billing audits.
Interprets and applies both internal and external policies and procedures.
Develops and implements new procedures as necessary.
Establishes, implements, and monitors Quality Control Procedures.
Provides continuing education regarding correct coding and documentation, and denial patterns to operations staff, managers and providers.
Maintains and distributes up-to-date coding information.
Routinely investigates the impact of coding on insurance reimbursement and designs effective, accurate and efficient coding workflows to facilitate compliant billing and optimal revenue.
Presents to large groups and creates and communicates educational coding materials in a timely and effective manner.