Manager Medical Group Coding

Job Summary

Plans, manages, organizes, controls, and oversees all daily functioning of the Virtua Medical Group Coders. Duties include ensuring ethical, accurate, and compliant coding for VMG, maintaining unbilled accounts at acceptable levels to support A/R, development of compliance and education programs, and oversight and engagement of colleagues. Responsible for workflow design, as well as formulation of and adherence to policies and procedures.

Identifies process opportunities to enhance coding and reimbursement, and compliance.

• Plans and manages daily functions of the VMG Coders. Ensures compliance with federal, state, and payer requirements. Ensures ethical and accurate coding, as well as review of provider assigned codes. Responsible to maintain A/R at an acceptable level and determine remediation plans for backlogs or workload increases. Responsible for implementing use of vendor services when departmental needs warrant additional staffing.
• Maintains quality, productivity, and workflow standards within VMG’s coding department. Identifies opportunities for enhancement of processes and develops workflow to support improvements. Ensures appropriate use of technology to support best practices. Ensures adherence to VMG, Government and Payor policies by management, coding staff and clinicians.
• Human resource management:
  Interviews, hires, trains, coaches, counsels, disciplines, terminates, evaluates, recognizes, and mentors coders. Performs payroll and associated functions. Maintains staff schedules.
• Develops and implements training plans for coding staff and ensures proficiency. Provides clear instruction and ensures staff accountability and adherence to established standards.
• Establishes and maintains productive relationships and communication with all providers and clinicians, as well as practice management and billing department. Offers suggestions for recommendations for resolution of problems and open issues. Collaborates with external colleagues to learn best practice and ensure Virtua is at the forefront for coding practice.
• Responsible for departmental adherence to budgetary guidelines and is able to justify and explain variances. Communicates with leadership regarding revenue improvement opportunities determined through course of documentation review.

• Expert knowledge of professional fee coding required (ICD-10, CPT, HCPCS, and other reimbursement methodologies), including compliance and audit requirements.
• 2 years of supervisory experience preferred or 5-7 years of coding experience.
• Excellent organizational, communication, and customer service skills.
• Ability to utilize Information Systems, including electronic health records, effectively.
• Ability to make sound decisions independently and provide guidance.

Bachelor’s or Associate’s degree in Health Information Management/other related field, or 5-7 years of relevant experience.

Certification as a CPC and/or CCS-P required.