Position Summary: Responsible for overseeing and managing the coding team, ensuring accurate and timely coding and documentation review of medical records while playing a vital role in optimizing revenue cycle processes, improving coding education and training programs, and implementing coding strategies that enhance operational efficiency and ethically maximize reimbursement. Requires a strong understanding of coding principles, healthcare regulations, and industry best practices.

Essential Duties and Responsibilities:

· Responsible for recruiting, hiring, and onboarding of new coding staff.

· Manage and supervise the coding team, providing guidance, support, and training as needed.

· Accountable for the training for all staff if needed and when applicable.

· Monitor coding staff productivity and quality, implementing process improvements as necessary.

· Identify and address coding-related compliance issues to ensure legal and company policies and procedures are followed.

· Conduct retrospective provider audits to ensure compliance and identify areas for improvement as needed.

· Review and analyze medical records to ensure accurate and appropriate coding.

· Provide multidisciplinary coding education when appropriate

· Provide coding expertise and guidance to physicians, nurses, and other healthcare professionals.

· Coordinate the ordering of all coding materials for the organization.

· Assist insurance follow up team with payer reconsiderations and appeals as warranted.

· Stay abreast of advancements in coding technology and software.

· Develop, implement, and maintain coding policies and procedures.

· Stay current on coding guidelines, regulations, reimbursement, and industry changes.

· Responsible for dissemination of information and changes to team members and providers

· Make recommendations to administration areas to improve for compliance purposes.

· Research and respond to coding questions from all areas within the organization.

· Collaborate with other departments to ensure coding accuracy and resolve coding-related issues.

· Perform regular reporting and analysis on coding trends, denials, productivity, or other department related metrics.

· Consider and capitalize on all automation opportunities while leveraging edit and rule functionality within the system to streamline workflows and optimize revenue.

· Attend education/training seminars to promote optimal efficiency and expertise.

Education: Credentialed Coder required (see credentials below).

Experience: Minimum of five (5) years of coding experience, orthopedic preferred, with at least two (2) years in a managerial or supervisory role.

Certificate/License: Minimum of one (1) is required: RHIA, RHIT, CPC, CCS-P

Physical Demands: Ability to sit for long periods of time.

Qualification and Performance Requirements:

• Thorough knowledge of CPT, ICD-10, and HCPCS coding principals, guidelines, and software.

• Knowledge of third-party payer fee schedules and reimbursement requirements.

• Skilled in establishing and maintaining effective working relationships with patients, medical staff, insurance companies, team members and providers.

• Proficient problem identification and resolution skills.

• Skilled in exercising initiative, judgment, discretion and decision-making to achieve organizational goals.

• Ability to delegate responsibility and authority to team members.

• Ability to effectively communicate and collaborate with diverse stakeholders and or third-party vendors.

• Proven leadership and team management capabilities.

• Proficient computer and typing skills.

• Ability to work with large amounts of data, in Excel, particularly via pivot tables.

• Proficient interpersonal and negotiation skills.

Pre-Employment background check, drug screen and TB test required for all new hires

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