Coding Operations Manager

Overview

Position:
Coding Operations Manager

Reports To:

Executive Leadership Team / Board of Directors

Exempt/Non:
Exempt, Full-Time

Education:

Certified Professional Coder (CPC minimum) or Certified Emergency Department Coder (CEDC preferred)

Experience:

Equivalent of an Associate’s degree and two to three years of relevant emergency department or general medical coding experience.

Coding Operations Manager is responsible for overseeing the medical coding team and ensuring the accurate and efficient coding of patient records for billing, compliance, and reimbursement purposes. Oversees insurance verification department. Needs to have skills with operational leadership, compliance oversight, team management, and process improvement within the healthcare revenue cycle.

• CODING OPERATIONS & OVERSIGHT:
  Oversee day-to-day operations of the medical coding team, ensuring timely and accurate coding of diagnoses, procedures, and services.
• Ensure that all codes (ICD-10, CPT, HCPCS, etc.) are applied correctly and consistently according to official coding guidelines.
• Distribute work evenly among coders based on volume, complexity, or specialty.
• Manage team schedules, collaborate with HR regarding time-off requests, and ensure adequate coverage.

• COMPLIANCE & QUALITY ASSURANCE:
  Conduct regular internal/external audits to ensure compliance with federal regulations (e.g., CMS, HIPAA) and payer requirements, address issues discovered.
• Stay current with updates/coding changes and educate staff on changes as needed, train new coding staff members.
• Research and Development of Compliance and Coding Standards.
• Assist in ensuring that the coding guidelines and processes for new clients adhere to all legal and regulatory requirements specific to the medical industry, creating a seamless integration for new contracts.

• TEAM LEADER SHIP & DEVELOPMENT:
  Provide training for new hires and ongoing education for existing staff.

• REPORTING & METRICS:
  Track coding productivity and quality metrics (e.g., charts coded per day, accuracy rates).
• Prepare reports for upper management regarding coding efficiency, denial trends, audit outcomes, etc.
• Identify trends, issues, or bottlenecks through performance data and propose process improvements.

• CROSS-FUNCTIONAL COLLABORATION:
  
  Work in collaboration with the RCM team to resolve coding/insurance verification related issues by working closely with team members and other departments to implement solutions.
• Collaborate with providers to clarify documentation and coding queries. New physician and APP education.
• Work with the Operations Director to monitor the financial health of the company.

Must be able to lift up to 15 lbs at times.

Prolonged periods of sitting at a desk on a computer.