Coding Manager Resume Samples
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Coding Manager Resume Samples
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CJ
C Jaskolski
Christiana
Jaskolski
3823 Sigmund Trail
Detroit
MI
+1 (555) 178 8586
3823 Sigmund Trail
Detroit
MI
Phone
p
+1 (555) 178 8586
Experience
Experience
Boston, MA
Coding Manager
Boston, MA
Moen-Gaylord
Boston, MA
Coding Manager
- Participates in departmental and hospital programs for quality assessment and improvement and works with department management to improve the services provided
- Assist with the ongoing development, interviewing, hiring and training of the HIM Coding staff. Perform corrective actions when necessary
- Monitors employee performance against established performance metrics
- Performs quality review on all hospital coders, providing feedback and education on areas identified as opportunities of improvement
- Plans, organizes and supervises the work and systems of one or more of the following Health Information Management programs
- Proactively provide information, direction, and updates relevant to coding to providers
- Provides the health care providers with feedback and education on clinical documentation practices as identified through the review process
Los Angeles, CA
Medical Coding Manager
Los Angeles, CA
Bailey-Oberbrunner
Los Angeles, CA
Medical Coding Manager
- Responsible for the daily operations of coding division including monitoring quality and quantity of workflow to ensure completion of work assignments
- Performs annual performance evaluations on staff
- Provides cost effective management of resources
- Work with our project management team determine which medical records validate HCCs submitted during the risk adjustment process
- Assists in the development of coding and abstracting policies and practice standards and communicates all policy changes as requested
- Oversees work assignments of system wide coding staff and adjusts work lists to accommodate volume and schedule changes
- Provides weekly reports to client and the Director of HIM Consulting
present
Phoenix, AZ
Production Coding Manager
Phoenix, AZ
Jacobson-Swaniawski
present
Phoenix, AZ
Production Coding Manager
present
- Establishes personal growth goals on an annual basis including training opportunities for self improvement
- Works hand-in-hand with cross-functional department managers and supervisors to meet company goals and objectives
- Utilizes data to develop monthly productivity metrics to track employee productivity and improve department efficiencies
- Ensures that a work schedule is provided for each of the Coders and RE-Orientation team members
- Creates development opportunities and promotes cross training to foster employee growth and advancement opportunities
- Provides technical expertise and support to meet company goals and objectives
- Monitors daily production schedule regularly and proactively addresses any obstacles to timely completion of jobs; Works hand-in-hand with cross-functional departments to meet delivery of manufactured products supporting the daily production schedule
Education
Education
Bachelor’s Degree in Health Information Management
Bachelor’s Degree in Health Information Management
Johnson & Wales University
Bachelor’s Degree in Health Information Management
Skills
Skills
- 3-5 years of experience in hospital coding
- ICD-9, DRG experience
- CPT-4
- Computer skills
- Prospective payment system experience
- Encoder software experience $
- CSS skills
- Previous supervision experience
- 4+ years of Acute Care (Inpatient & Outpatient)
- Training in ICD-9 and/or CPT coding
15 Coding Manager resume templates
Read our complete resume writing guides
1
Coding Manager Resume Examples & Samples
- 3-5 years of experience in hospital coding
- ICD-9, DRG experience
- CPT-4
- Prospective payment system experience
- Encoder software experience $
- CSS skills
- Previous supervision experience
2
Coding Manager Resume Examples & Samples
- 4+ years of Acute Care (Inpatient & Outpatient)
- Training in ICD-9 and/or CPT coding
- CCS, RHIT, or RHIA
- Strong HCC skills and APC Coding
- Ability to develop and provide high quality in-service and seminar of Coding and Coding related topics
- Detail oriented $
- Associate or Bachelor’s degree in Health Information Management or Science
- AHIMA ICD-10-CM/PCS Trainer
3
Coding Manager Resume Examples & Samples
- 3+ years of Coding experience in an Acute Care setting
- RHIA, RHIT, CCS and/or CPC license
- Knowledge of DSM5
- Hospital Coding background
- Previous Leadership experience
4
Him Inpatient Coding Manager Resume Examples & Samples
- Centers for Medicare and Medicaid Services
- UHC
- Health Information Portability and Accountability Act
- North Carolina State Privacy Statutes
- Joint Commission Standards
- North Carolina State requirements for record content, management, retention and destruction
- ICD-10-CM and PCS coding guidelines and conventions
- CPT-4 coding guidelines and conventions
- NCDs, LCDs, CCI, Modifiers
- Prospective payment systems-hospital/technical and professional services reimbursement methodologies (DRGs, APCs, RBRVUs)
- Principles and practices of function to be managed
- Federal, state and local regulations governing Health Information Management
5
Production Coding Manager Resume Examples & Samples
- Applies Good Manufacturing Principles in all areas of responsibility
- Demonstrates and drives the Thermo Fisher values – Integrity, Intensity, Involvement and Innovation (The Four I’s)
- Monitors and tracks staff attendance and punctuality; addresses any non-compliance with policy
- Delivers regular, constructive performance feedback to employees employing coaching, training and progressive discipline, if appropriate, providing ongoing monitoring and tracking of progress
- Identifies resource needs, hires, trains, evaluates and sets standards, goals and objectives for direct reports
- Conducts all annual employee development initiatives; mid-year evaluations, year-end evaluations
- Holds staff accountable for their ongoing performance to specified standards
- Develops training plans to suit growth and improvement efforts. Provides individual training for new department members as needed. Trains staff on all new and revised procedures and work instructions
- Creates development opportunities and promotes cross training to foster employee growth and advancement opportunities
- Provides input into departmental budgets and recommendations for new equipment
- Monitors daily production schedule regularly and proactively addresses any obstacles to timely completion of jobs; Works hand-in-hand with cross-functional departments to meet delivery of manufactured products supporting the daily production schedule
- Provides technical expertise and support to meet company goals and objectives
- Establishes personal growth goals on an annual basis including training opportunities for self improvement
- Oversees the Investigation of Internal Incidents and Customer Complaints resulting from problems originating in the manager's responsible area. Prepares the reports, assigns responsibilities for corrective and preventive measures
- Analyzes nonconformance’s/customer complaints and observations in order to facilitate the identification and implementation of corrective actions through the department. Tracks and trends non-conformances, complaints, and internal investigations
- Responsible for ensuring the completion of action items agreed to within the investigation reports
- Addresses all “Corrective & Preventative Actions” and “Root Cause Analysis” from internal or client audits
- Manages, administers & generates Standard Operating Procedures, Work Instructions, Master Forms and checklists that support company goals and objectives and enhance product improvement
- Continually improves processes to operate in the highest state of efficiency and control
- Utilizes data to develop monthly productivity metrics to track employee productivity and improve department efficiencies
- Monitors and tracks all logbooks and electronic logs (iComply, Trackwise, etc) on an ongoing basis to insure accuracy and completeness
- Fosters continuous process improvements and problem resolution leveraging internal Practical Process Improvement (PPI) methodologies as appropriate
- Conducts all activities in a safe and efficient manner
- Ensures that a work schedule is provided for each of the Coders and RE-Orientation team members
- Ensures that all equipment for Coding and Re-Orientation is maintained as per procedure. This includes keeping up with all current preventative maintenance practices on a daily basis
- Ensures that the production areas are in a constant state of cleanliness and audit readiness
- Ensures that all Coders and Re-Orientation personnel are trained on current procedures and are working to increase their skill level for current tasks
- Works hand-in-hand with cross-functional department managers and supervisors to meet company goals and objectives
- Associates Degree (Bachelors Degree Preferred)
- 2+ years knowledge of how to operate and manipulate basic printer technologies used in label printing with variable data
- 4+ years experience working intermediately with Microsoft Word, Excel, PowerPoint, and Outlook
- Previous experience in clinical packaging or clinical labeling environment preferred
- Ability to work independently/in a group setting/with little direction/with direct supervision
- Strong Managerial skills
- Strong Communication Skills (oral & written)
- Ability to lead projects for department expansion and equipment upgrades
- Detail/big picture orientation, tactical/strategic orientation
- 5% Travel
- Associates Degree
- IND-CCG
6
Clinical Coding Manager Resume Examples & Samples
- 5+ years of experience in Healthcare Claims Data
- CPT Coding knowledge
- Expert understanding of Healthcare Coding (CPT) and how to organize and analyze it
- Out of Managed Care experience
7
Medical Coding Manager Resume Examples & Samples
- Responsible for the daily operations of coding division including monitoring quality and quantity of workflow to ensure completion of work assignments
- Serves as primary Coding department representative for resolution and improvement of revenue cycle initiatives/issues
- Actively works and understands the DNFB/DNFC process
- Communicates with HIM Director to support revenue cycle activities and key performance indicators
- Assists in the development of coding and abstracting policies and practice standards and communicates all policy changes as requested
- Oversees work assignments of system wide coding staff and adjusts work lists to accommodate volume and schedule changes
- Identifies need for educational sessions in collaboration with audit team
- Provides educational support and training of coding and documentation practices for all of coding and clinical staff
- Hires, trains, counsels, disciplines and terminates when necessary coding staff (onsite and remote)
- Performs annual performance evaluations on staff
- Provides cost effective management of resources
- Authorizes and coordinates payroll
- Assesses scanning/coding workflow processes, identifies innovative solutions when improvement is needed and initiates changes
- Acts as a liaison to CDI specialists to facilitate documentation issues identified by coders
- Acts as a liaison to physicians to facilitate any Physician Query questions
- Reviews physician queries submitted by coders for leading or non-compliant language
- Assists in developing new query forms as needed
- Provides weekly reports to client and the Director of HIM Consulting
- Interacts with billing office, physicians, IT, and hospital personnel to resolve coding/billing issues
- Works on multiple IT platforms, including patient finance, encoders, as well as Precyse and client IT systems
- Participates in the processing of RAC audits as well as all types of internal and external auditing
- Stays abreast of the differences in payment processes amongst insurance payers
- Possesses a solid grasp of the charge master, revenue codes, processing patient type changes, cancelled accounts, and working multiple edits
- Maintains strict physician and patient confidentiality and follows state, federal and hospital guidelines for the release of information
- Maintains current skill set with regard to government regulations, compliance and TJC and DNV guidelines
- Keeps abreast of new legislation and regulations that affect HIM
- Participates on all applicable committees and professional organizations and maintains personal and professional education and growth
- The HIM Coding Manager Consultant may need to travel 100% of the time
- RHIA or RHIT and Associates or Bachelor’s Degree in Health Information Management or related field
- Candidate must be able to code both inpatient and outpatient records
- Manager is required to be able to code and audit
- Possesses a strong grasp of MS-DRGs, APCs, and the transition to ICD-10
- Requires strong interpersonal skills to work with physicians and staff to implement positive change
- Demonstrated customer-oriented management style
- Demonstrates knowledge of computer technology and automated system designs for HIM; computer knowledge of MS Office including Word, Excel, and PowerPoint
- Must maintain credentials through completion of required CE requirements
- Travel may include weekday and / or weekend travel. Must also have high speed internet access and experience with remote access, set-up, and troubleshooting technical issues when working remotely
- Supports our Compliance Program by demonstrating adherence to all relevant compliance policies and procedures as evidenced by training participation and daily practice; notifying management when there is a compliance concern or incident; demonstrating knowledge of HIPAA Privacy and Security Regulations as evidenced by appropriate handling of patient information; promoting confidentiality and using discretion when handling patient information
- CCS
- 5+ years of experience as a Coding Manager
- Available/felxible to travel 50% of the time or greater
8
Medical Coding Manager Resume Examples & Samples
- 3-5+ years of medical coding/claims experience
- Prior direct management of coding, education, or quality audit resources
- One or more CPC or AHIMA certification(s) maintained for greater than 3+ years
- Excellent communication and interpersonal skills required
- Must be task oriented and have ability to prioritize multiple projects with competing priorities
- Experience maintaining high revenue volume and/or experience working with large multi-specialty physician groups or high volume physician groups
9
Coding Manager Resume Examples & Samples
- Coaches and develops of supervisory team members
- Works with leadership team to address provider needs and ensures communication is helpful, effective, and consistent
- Ensures adherence to all departmental policies
- Develops, implements, and monitors quality assurance reviews
- Assesses, implements, and continuously monitors workflow and volumes to ensure workload is balanced among team members
- Assesses and reacts to workflow changes related to departmental growth
- Ensures effective communication with both internal and external customers
- Develops, implements, and monitors a comprehensive training program to include career ladder development. Addresses departmental training needs based on team member performance and quality reviews
- Conducts quality assurance reviews as needed. Provides education as a result of these reviews
- Stays abreast and communicates coding changes (i.e. new codes, new technology, payor requirements)
- Monitors key performance indicators (KPIs) to include, but not limited to, denials, AR Trends, edit volumes, and charge lag
- Participates in strategic planning and design in coding, regulatory, and system changes that impact coding, reimbursement, and compliance
10
Medical Coding Manager Resume Examples & Samples
- Day to day activities of a team of experience medical coders
- Work on CMS and HHS risk adjustment audits as well as compliance programs for health plans
- Work with our project management team determine which medical records validate HCCs submitted during the risk adjustment process
- Educate clinical staff regarding coding and documentation requirements associated with ICD coding and risk adjustment
- Lead this team to meet deadlines according to project SLAs, report project metrics to leadership, ensure coding compliance according to ICD and coding clinic guidelines, offer coaching to medical coders, streamline processes, and maintain compliance expectations
- Work in a fast paced environment with tight deadlines
- Work with internal and external coding partners and need to continue build and maintain these relationships as we grow
- AHIMA or AAPC Coding Credential with 5+ years’ of coding experience
- Ability to lead and motivate a team to accomplish project deadlines
- Good communication skills - will be interacting with internal and external clients as well as leadership positions and vendors
- Familiarity with risk adjustment
11
Coding Manager, Professional Inpatient Resume Examples & Samples
- Bachelor’s degree in Health Information Management, Business, or 6 years of related work experience
- 3 years of coding experience
- Applicable coding certificate
- Registered Health Information Administrator plus applicable coding certificate
- Five years of coding experience and two years of management experience
12
Coding Manager Resume Examples & Samples
- Alongside the DHIM, direct the functions of the Coding division of the HIM department
- Participate with various and record review committees / activities
- Assist with the ongoing development, interviewing, hiring and training of the HIM Coding staff. Perform corrective actions when necessary
- Lead special HIM projects related to Coding
- Develop and deploy HIM systems conducive to departmental success
- Monitor systems and sets standards for quality and ethical practices within the Coding division of the HIM department
- Participate in the development of departmental policies and procedures
- Monitor DNFB and coding days daily and direct expeditious processing to ensure compliance
- In the absence of the Director, the Coding Manager has expanded responsibilities related to department functions and performs duties necessary to manage all functions
- Interacts with billing office, physicians, IT, and hospital personnel to resolve coding/billing issues
- Actively works and understands the DNFB/DNFC process
- Works on multiple IT platforms, including patient finance, encoders, as well as Precyse and client IT systems
- Stays abreast of the differences in payment processes amongst insurance payers
- Possesses a solid grasp of the charge master, revenue codes, processing patient type changes, cancelled accounts, and working multiple edits
- Participates in the processing of RAC audits as well as all types of internal and external auditing
- Acts as a liaison to CDI specialists to facilitate documentation issues identified by coders
- Acts as a liaison to physicians to facilitate any Physician Query questions
- Reviews physician queries submitted by coders for leading or non-compliant language
- Assists in developing new query forms as needed
- Revises and updates coding policies and procedures in collaboration with HIM Director, as requested
- Maintains strict physician and patient confidentiality and follows state, federal and hospital guidelines for the release of information
- Supports our Compliance Program by demonstrating adherence to all relevant compliance policies and procedures as evidenced by in-service attendance and daily practice; notifying management when there is a compliance concern or incident; demonstrating knowledge of HIPAA Privacy and Security Regulations as evidenced by appropriate handling of patient information; promoting confidentiality and using discretion when handling patient information
- RHIA or RHIT required
- 5+ years of Coding Management experience (in can acute care facilty with 250+ bed count) including DNFB management, denials management and periodic auditing of charts to assure quality of coding
- Experience with 3/M encoder is required
- CCS or CPC also preferred but not required
- Candidate should demonstrate excellent verbal and written skills as well as demonstrate working knowledge of Excel Spreadsheet
- Experience with HIM departmental staff supervision
- Medical Coding inpatient and outpatient experience in a hospital setting
- Extensive knowledge of HIM functions and processes
- Knowledge of information systems and healthcare application
- Experience with McKesson HPF and Paragon
- Experience with Computer Assisted Coding implementation
13
MRA Coding Manager Certified Professional Coder With RN Resume Examples & Samples
- AAPC Coding certification
- RN, LPN or LVN
- Demonstrated consultation and presentation skills
- MRA, STARS and HEDIS knowledge
- Knowledge of CMS processes and procedures
- Comprehensive knowledge of Microsoft Word, Excel and PowerPoint
- Bachelor's Degree is preferred
- Bilingual (English/Spanish)
14
Transcend MRA Coding Manager Resume Examples & Samples
- AAPC Coding certification
- Demonstrated consultation and presentation skills
- MRA, STARS and HEDIS knowledge
- Knowledge of CMS processes and procedures
- Strong presentation skills, verbal and written communication
- RN, LPN or LVN
- Comprehensive knowledge of Microsoft Word, Excel and PowerPoint
15
Billing & Coding Manager Resume Examples & Samples
- 1 Adheres to and supports the mission, purpose, philosophy, objectives, policies, and procedures of Tenet Practice Resources
- Demonstrates support for the Tenet Practice Resources Corporate Compliance Program by being knowledgeable of compliance responsibilities as expressed in the Code of Conduct; adhering to federal and state laws, rules, regulations, and corporate policies and procedures policies that affect his/her specific job functions/responsibilities; and reporting compliance issues/concerns in a timely and appropriate manner
- Audits charts on a scheduled basis to meet compliance standards
- Act as the network’s liaison to provider representatives for insurance carriers
- Assist with day to day billing functions for market practices as needed
16
M HIS Client Coding Manager Resume Examples & Samples
- Participates in the development of strategic goals and assures implementation of objectives related to the coding operations business unit
- Performs monthly performance audits on direct reports to assure that quality and productivity metrics are achieved
- Develops individual coding improvement activities based on coder results
- Serves as an escalation resource for coding issues and questions from direct reports, independent contractors, outsourced coders, and clients
- The coding supervisor works directly with the coding operations leadership team to develop ongoing coding excellence within operations
- Manages the career development and performance of the employees directly reporting to this role
- Handles special projects as assigned by the manager of coding operations
- Must be office based
- Associate’s Degree or higher from an accredited University and/or AAPC or AHIMA coding certifications in lieu of the education requirement
- Minimum of one or more (1+) years of working with physician documentation
- Minimum of two or more (2+) years of experience within HIM industry
- Minimum of two or more (2+) years of client management experience
- AAPC or AHIMA coding certifications
- Working understanding of CPT and ICD-10 codes
- Previous experience using computer assisted coding, reports and information storage and retrieval
- Experience with MS Word, Excel, Power Point, and technical applications
- Previous coding management experience
- RCC certification
- ICD-10 trained
- Experience navigating through Electronic Health Records and paper charts to identify sufficient documentation of billed services preferred
- Meeting facilitation skills internal/client facing
17
Coding Manager Resume Examples & Samples
- Provides day to day supervision and coordination of staffing assignments for the Coding team
- Conducts technical training and coaching sessions for new employees and existing staff
- Strategically supports the continued development of the medical record review process and resource tools through project team involvement and leadership
- Performs quality audits on internal coding team on a quarterly basis
- Ensure that Optum Policies and coding standards are consistently applied in all processes
- Ensure that all coders meet education, quality and productivity standards
- Provides input and feedback on employee performance and conducts counseling and disciplinary actions as necessary
- Works with National CDQI team to ensure local standards meet National objectives
- CPC, CCS or RHIT certification
- 3+ years’ experience Management
- 2+ years’ experience in Risk Adjustment
- 6+ years’ experience ICD9 / ICD10 coding
- 2+ years’ provider education/query experience, communicating directly with providers
- Strong knowledge of CMS Risk Adjustment and ICD coding requirements and regulations
- Proficient knowledge of HEDIS / Stars
- Experience with retrospective and concurrent chart review programs for Medicare Advantage Enrollees
- Ability to interact with multiple levels of management including, clients, vendors, and healthcare providers
- Must be local to Farmington, CT area – will be able to telecommute ~75% of time
- Up to 30% travel required - local and non-local to onsite meetings
- Must be able to continuously meet the requirements of a telecommuter
- Bachelor’s degree preferred, significant relevant experience may be substituted for degree
- Familiarity with government pay for performance programs
- Experience managing a remote coding team
18
Coding Manager Resume Examples & Samples
- Develop and maintain an organizational structure to maximize effectiveness, quality and productivity of the coding function
- Ensure employees can easily access and utilize information (e.g., industry standards and reference sources/guides) needed to perform the coding function
- Identify EMR system issues with approved templates and mange problem resolution with matrix partners
- Develop and/or enhance Coding policies, procedures and SOPs, coding tools, etc
- Develop and/or enhance quality reporting metrics for internal monitoring and reporting
- Establish communication mechanisms with key stakeholders (Network Operations. Providers and Health Plan) to ensure processes remain in sync to ensure on-going success
- Monitor, measure and improve compliance with policies and procedures and standard industry practice
- Identify mitigation strategies and take proactive approach to resolve issues and address impacts to key stakeholders
- Measure and manage departmental quality metrics to ensure staff, matrix partners and client requirements are met. (Daily, Weekly and Monthly)
- HSD or equivalent; Bachelor’s degree preferred
- Certified Professional Coding (CPC), Certified Risk Adjustment Coder (CRC) or corresponding certification from AHIMA or AAPC
- Minimum 5 years of related coding management experience required
- Additionally, preferred experience to include coding management role of a minimum of three years in one or more of the following areas -provider office, health care system/hospital, outpatient setting or Medicare Advantage organization. This experience to include direct staff management, direct physician communication, new staff training, onboarding, mentorship, coaching & team building
- Ability to effectively present information and respond to questions from groups of managers, providers, customers and market leadership. Clear understanding of and ability to implement, Coding Quality standards and goals
- Ability to solve practical problems
- Strong leadership skills including demonstrated ability to confront resistance to change in a fast paced highly-regulated environment
- Experience in Microsoft products such as Word, Excel, Outlook, Internet Explorer
- Data analytic skills to review data, understand trends, compile presentations for stake holders
- Ability to work with, effectively communicate and achieve results in collaboration with all areas of the organization
- Experience with Medicare Advantage preferred
- Travel within market areas – 50% (mostly day travel but may require overnight travel)
- May require evening, night or early morning meetings based on organizational needs
19
Remote Coding Manager Resume Examples & Samples
- 2+ years of health care revenue cycle management experience (physician practice experience preferred) 3+ years of physician coding and abstracting experience
- 3+ years supervisory experience required
- Thorough knowledge of coding practices and official guidelines, HCPCS, ICD-9 and CPT codes
- Proficient in Excel, M/S Word and general PC applications
- Strong Excel and Access skills preferred
20
M HIS Client Coding Manager Resume Examples & Samples
- Minimum of an Associate Degree or higher from an accredited University
- Minimum of one (1)+ year of working with physician documentation
- Minimum of two (2)+ years of professional fee coding experience
- Minimum of two (2)+ years of client management experience
21
Coding Manager Resume Examples & Samples
- Be the subject matter expert for verbatim comments, coding/categorization and the coding tool being used by the team
- Pursue innovation by staying up-to-date on market research industry trends and coding solutions
- Coach, develop and monitor schedules of hourly Cast
- Balance and re-prioritize workload as needed
- Assist Cast with day-to-day coding & analysis work as needed
- Ensure that projects are delivered on time and according to expectations
- Develop and maintain training materials
- Oversee and maintain department verbatim comment policy and corresponding goals/metrics
- Communicate to Cast and lead staff meetings with the help of the Consumer Insight Manager
- Foster relationships with other internal departments and project stakeholders
- 3-5 years of experience with coding verbatim comments and/or text analytics
- Demonstrated computer proficiency within a Windows environment including Microsoft Word, Advanced Excel (pivot tables, h & v lookup, macros), PowerPoint, Outlook
- Knowledge of statistical software associated with role (eg. Ascribe, SPSS/SAS)
- Demonstrated problem solving skills, as well as continuous improvement process skills and strong interpersonal skills
- Demonstrated strong work ethic and high intellectual curiosity
- Demonstrated experience in project management
- Flexible and nimble - can adapt to changing priorities
- Ability to partner and work well with various levels of the organization
- 3-5 years experience in project management
- Demonstrated experience using Ascribe or other survey coding tools
- Demonstrated experience with statistical analysis, proficiency in SPSS/SAS and Tableau
- Social listening experience and/or experience working with social media analysis
- Working knowledge of SAP and Workbrain
- Experience with Microsoft Access or other similar database software
22
Market Coding Manager Resume Examples & Samples
- Serve as coding SME including but not limited to basic E&M, specialty specific surgery coding and ICD-9/ICD-10 -CM for practices within his/her individual market
- Work with providers, coders, billers, clinical and non-clinical office staff to answer coding questions and provide guidance, as needed
- Work with the Coding Operations and Clinical Operations Performance Standards teams and market coding team to complete pre-bill clearance audits and ensure feedback is given to physicians and coders in a timely manner so bill holds can be released within a 60 day or less window of onboarding
- Monitor market bill hold reports and market new provider start dates to ensure the pre-bill clearance process is performed for all new providers
- Maintain a grid indicating providers who have been “cleared” to bill by Clinical Operations Performance Standards team and compare grid to the daily Nextgen or other EPM/EHR system bill hold report to ensure “cleared” providers are no longer in a bill hold status and investigate and resolve discrepancies
- Work with Regional and/or National Coding Operations Manager to perform coder QA assessments for new coders or coders assigned to a new specialty
- Monitor compliance central for remediation plans, etc. for individual market coders and/or biller, as necessary
- Collaborate with Coding Educator, if applicable, to run quarterly E&M code utilization reports to monitor provider coding patterns and conduct spot checks of documentation for providers whose E&M patterns deviate from the norm
- Perform annual provider E&M documentation reviews of 5 encounters for all providers in the markets to ensure accurate selection of evaluation and management and procedure codes to be in compliance with Medicare, Medicaid and other payer requirements
- Collaborate with Coding Educator, is applicable, to develop provider education, as needed, based upon these reviews
- Oversee the day to day coding operations of the market by monitoring pending charges, kept appointments with no charges and task reports, etc. to ensure coders and/or billers are clearing their work ques in a timely manner. Keep Regional Coding Operations Manager informed of any issues that prevent timely submission of claims
- Assist individual market coding staff with day-to-day coding duties, as needed, including but not limited reviewing provider documentation to ensure assignment and sequencing of procedural and diagnostic codes to ensure accurate and timely submission of claims
- Assist market coding staff work coding tasks, as needed, to ensure timely processing of payer denials and adherence to RCM KPI metrics
- Ensure market coding resources have the tools necessary to successfully perform their task (coding books, coding software, access to sharepoint for newsletters, etc.)
- Participate with special projects and other duties as assigned
- Must have a high school diploma or equivalent. Associate’s degree in related field preferred
- Completion of college level courses in medical coding/billing, medical terminology, anatomy and physiology, highly desirable
- Must be certified through the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC), Preferred OR Must be certified through the American Health Information Management Association (AHIMA) as a Certified Coding Specialist Physician Based (CCS-P)
- Minimum of five years’ experience in a medical Coding position, including three years’ experience in a management role
- Expert working knowledge of CPT-4, ICD9, ICD-10-CM and HCPCS codes as well the National Correct Coding Initiative (NCCI) edits
- Strong understanding of coding and documentation issues facing the healthcare industry
- Remains current on reimbursement regulations and coding guidelines and keeps the market informed of changes
- Ability to analyze data
- Skilled in exercising initiative, judgment, problem solving and decision making
- Good communication skills and ability to effectively manage staff
23
Coding Manager Operations Resume Examples & Samples
- 8+ years of relevant experience in a healthcare environment
- 3+ years managerial/leadership experience
- Graduate degree
- Healthcare coding/billing experience required
- Healthcare Revenue Cycle Management services experience
- Previous experience in UAE is desirable
- Certification from AAPC/AHIMA is preferable
- Knowledge on ICD-10 billing/coding
24
Client Benefits Coding Manager Resume Examples & Samples
- Recommending operational improvements both strategically and in the day-to-day application of organizational policies and procedures
- Actively managing the performance of staff members according to established Key Performance standards
- Developing a culture of collaboration and accountability
25
Coding Manager Resume Examples & Samples
- Provides input regarding departmental budget specific to area of responsibility
- Directly impacts days not final billed (DNFB), overall A/R and monthly revenue collection
- Computer training: HBOC Star; 3M Coding & Reimbursement software; SoftMed Systems; MS OFFICE; Horizon Patient Folder; Groupwise; DVI Dictation System; External Transcription Agency Systems
- State and federal regulations regarding patient confidentiality
- Thorough/detailed knowledge of ICD-9-CM and CPT coding systems
- Skilled in performing quality assessment/analysis
- Must display excellent interpersonal skills
- Associate Degree in Health Science Administration/HIM Technology , minimum
- Registered Health Information Technician (RHIT) certification
- Registered Health Information Administrator (RHIA) certification
- Minimum three years supervision of coding staff, required
- Duties may require driving an automobile to off- site locations
- Ability to sit for extended periods of time
- Capacity to work independently in a virtual office setting or at hospital setting if required to travel for assignment
26
System Coding Manager Resume Examples & Samples
- Education:Associate of Science degree in Health Information Technology or a Bachelor of Science degree in Health Information Management required. Must attend educational programs to maintain the required CE hours
- Experience:Must have two to three years’ experience within an acute care setting with emphasis on ICD-9-CM and CPT coding. Previous supervisory experience desired
- Licensure/Certification/Registration:RHIT or RHIA certification required
- Skills:Near visual acuity for close paperwork is required. Good hearing ability to operate telephone and assist physicians, office personnel, and general public effectively. Must be able to follow directions and adjust to change. Demonstrated typing ability required
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Coding Manager Resume Examples & Samples
- Client management - Monitors key metrics and other documentation to effectively manage client satisfaction and retention. Proactively manages client requests for additional information as it relates to: coding, documentation trends, coding denial trends, system interfaces, coding compliance, and regulatory changes. Identifies trends and recommends actions to ensure optimization of coding operations and workflows. Stays abreast of internal and external changes to understand current and future state and provide value to the client. Identifies client improvement opportunities related to coding to enable the most efficient workflows for the client’s account receivable
- Manages Coding Operations Team(s): - Manages a team of supervisors and leads in coding operations and meeting goals and objectives. Acts as an escalation point for the team base as needed
- New Client Implementations - Collaborates on new client implementations including: contract review, development of workflows and operational setup. Assists with new client implementations including system interfaces, system testing collection/creation of coding pathways, and acquiring and training of coding resources
- Reporting & Data Analysis - Creates meaningful reports (ad hoc or periodic) pertaining to various related metrics (i.e. backlog, quality scores, RAI status and reasons, documentation opportunities, etc). Interprets data to provide trend analysis and quickly identifies and communicates areas of opportunity and impact. Partners with Client Management, Revenue Cycle Operations and/or other client-facing roles to develop action plans and make value-based recommendations
- Manages Customer Satisfaction – proactively managers and resolves customer issues. Tracks progress and opportunities across coding operation. Alerts customer to any coding changing areas impacting revenue or workflow. Addresses issues openly and quickly Maintains relationships with key client contacts that fosters an environment to drive client performance and minimize attrition
- Grows Footprint in Own Service Area – ensure key customers are referenceable promoters to support sales. Provides guidance on new/current service offerings based on industry trends and changing client needs
- Client Invoicing – reviews or prepares coding only client invoice information to ensure accuracy prior to client receipt
- Collaborates with other BU Success Teams - Works collaboratively across functions to ensure operational excellence related to AR, payments, customer service, client management and all related services
- Other – other duties not addressed above
- 3-5+ years of medical coding/claims experience
- Prior direct management of coding, education, or quality audit resources
- One or more CPC or AHIMA certification(s) maintained for greater than 3+ years
- Excellent communication and interpersonal skills required
- Must be task oriented and have ability to prioritize multiple projects with competing priorities
- Experience maintaining high revenue volume and/or experience working with large multi-specialty physician groups or high volume physician groups
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Coding Manager Resume Examples & Samples
- Monitors production and turnaround time
- Monitors quality outcomes of coding staff in coordination with audit team
- Monitors cases placed on hold by remote coding staff and assists in resolution
- Identifies and implements improvement measures that will enhance department operations and customer service
- Monitors and reports all required hospital performance measures which may include developing department goals and assisting in the assessment of goal attainment and regulatory compliance
- Provides orientation for all new employees
- Provides support, schedules and tracks coding team staff meetings
- Registered Health Information Technician (RHIT) or; Registered Health Information Administrator (RHIA) or; Certified Coding Specialist (CCS) or; Two plus years medical records experience with at least one year of leadership experience preferred and at least two years of technical coding experience
- Conflict resolution, discretion, diplomacy, tact and listening skills
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Regional Coding Manager Resume Examples & Samples
- Coordinates work assignments of system wide coding staff and adjusts work lists to accommodate volume and schedule changes
- Monitors production and turnaround time
- Monitors quality outcomes of coding staff in coordination with audit team
- Maintains schedule of all remote coding staff
- Monitors cases placed on hold by remote coding staff and assists in resolution
- Provides cost effective management of resources for the assigned work unit
- Identifies and implements improvement measures that will enhance department operations and customer service
- Monitors and reports all required hospital performance measures which may include developing department goals and assisting in the assessment of goal attainment and regulatory compliance
- Provides interpretation of function or department policies
- Maintains coding staff employee files and tracks annual performance evaluations
- Provides orientation for all new employees
- Provides support, schedules and tracks coding team staff meetings
- May perform coding quality audits
- May participate in daily work load
- May assist with resolution and improvement of revenue cycle initiatives/issues
- May perform other duties as necessary to meet company and department objectives
- Registered Health Information Technician (RHIT) or; Registered Health Information Administrator (RHIA) or; Certified Coding Specialist (CCS) or; Two plus years medical records experience with at least one year of leadership experience preferred and at least two years of technical coding experience
- Must maintain credentials through completion of established CE requirements
- Experience in computerized encoding and abstracting in a Windows-based environment preferred
- Analytical ability to gather and interpret data to identify discrepancies, problems or issues, to determine compliance with regulations, policies and procedures and to apply sound judgment
- Adaptability, creative problem solving and organizational ability
- Ability to manipulate and interpret data in database to support operational needs
- Communication and interpersonal skills for contact with internal and external customers to obtain and interpret a variety of information based on knowledge of departmental practices, hospital policies and programs and specific technical and regulatory knowledge
- Conflict resolution, discretion, diplomacy, tact and listening skills
- Leadership skills such as accountability, decision-making, coaching and counseling
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Clinical Coding Manager Resume Examples & Samples
- May lead special project teams departmentally and divisionally. Support TA MD in deliverables to Product Safety Team and review exceptions with Management
- Coordinate quality assurance activities and overall assessment of quality programs for assigned compounds
- Function as subject matter expert for compound safety both within Safety Management and Clinical Teams and provide guidance on regulations and their impact on Safety Management processes/procedures
- Participate and lead multi-disciplinary teams and projects and ensure area maintains thorough knowledge of product(s), safety-related issues, labeling, key product or clinical issues and current records of required product information
- Accountable for total project scopes as delegated by Assistant or Associate Director
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Coding Manager Resume Examples & Samples
- RHIA or RHIT with CCS certification
- Minimum of Associate’s degree, Bachelor’s degree preferred. Master’s degree most desirable
- Proficient with 3M Encoder
- Proficiency in Microsoft applications, including Outlook, Word, Excel and Power Point
- Familiarity with CDI software (i.e., JATA, MIDAS, Optum, Chartwise)
- Knowledge of Joint Commission requirements and federal and state guidelines applicable to health record completeness and patient privacy rights
- Willingness to evaluate current processes, offer suggestions for improvement, and adapt to change
- Excellent interpersonal skills to work closely with physicians, staff, and other hospital personnel and the ability to make presentations to diverse groups
- Prefer five years’ experience in coding at acute care teaching hospital
- Prior management experience prefered
- Experience with MEDITECH and/or HPF McKesson preferred
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Coding Manager Resume Examples & Samples
- Provides consultation, leadership, and expertise to internal management in the planning, implementation, and delivery of coding education
- Assesses the educational needs of coding staff, management, and physicians and develops programs or researches educational resources to meet those needs
- Helps to develops training materials and coding aids for both formal training and use by coders in daily work
- Identifies and evaluates innovative educational methodology that may be appropriate for the targeted audience; incorporates new methodology as appropriate to enhance and update the effectiveness of education and skills development programs
- Actively works on site at the clinics conducting specialized training in coding and related documentation and coding issues; helps identify and document appropriate codes and procedures for reporting, as appropriate
- Serves as a technical resource for all involved personnel; ensures that information is accurate and current, meeting official coding guidelines
- Oversees and coordinates continuing education for coding staff; offers recommendations for credentialing and certification
- Develops and implements a comprehensive educational plan for all clinical specialty coding
- Participates in the hiring process and educational planning for coding staff
- Performs miscellaneous job-related duties as assigned
- Ability to identify and interpret strategic and operational training/development needs
- Demonstrated ability to develop and implement strategic, responsive training and development plans & programs
- Knowledge of HCC and CDI development and training
- Knowledge of adult learning theory and methodologies
- Familiarity with professional coding societies and resources
- Strong oral communication skills and the ability to deliver presentations to large groups
- Advanced verbal and written communication skills
- Experience working with physicians regarding medical coding practices
- Experience working in team environment and/or developing teams
- Ability to share knowledge in an effective way that enhances learning and application of new skills
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Coding Manager Resume Examples & Samples
- Takes primary responsibility for all daily operations at Customer site
- Communicates escalations as needed to Director of HIM Operations
- Provides a focused, warm and organized onboarding experience for new employees as they transition from the recruiting process to Operations
- Provides employees with timely communication in response to Customer related issues as well as any internal Peak related questions to ensure a successful Peak experience
- Monitors workflow, productivity and quality at all Customer sites
- Monitors, assesses and assigns workload for all employees
- Monitors employee performance against established performance metrics
- Conducts performance reviews, at a minimum, annually and interim as appropriate or performance required
- Identifies coder educational needs through continuous accuracy rate monitoring
- Monitors and recommends staffing levels based on volumes and project goals
- Proactively coordinates with each Customer site to ensure timely and appropriate staffing including backfill, vacations, ramp, and support for each work type
- Develops and maintains supportive and positive relationships with all employees
- Serves as Subject Matter Expert (SME) for all coding related questions (internal & external)
- Monitors and enforces compliance and quality program
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Revenue Cycle & Coding Manager Resume Examples & Samples
- 30% Product Service Expansion Management
- Within new or expanded services, deliver RCM and coding expertise against defined Product initiatives. Provide necessary industry or functional insight to relative teams such as R&D, UX, business development, sales, product marketing, and operations that result in successful prioritization and execution against strategic projects
- Define boundaries in athenahealth’s co-sourcing framework between what work is tied directly to the patient care process (and which the client uniquely positioned to do), and what work should be centralized by athena or its partners. Support an opinion on measures of success in each
- Drive and execute the relative pilots/alpha/beta testing experiences, from the Product standpoint, including recruitment of customers/prospects, identification and organization of targeted learnings to bring an opinion to other teams, gap-filling, and service requirement to GA - affording overall program support to all the various stakeholders. Collaborate with stakeholders to determine and prioritize needs to support program goals and advise cross-team improvements
- 30% Quality Management
- Act as a trusted advisor to Service teams, targeting customer-centric RCM experiences for improvement, conveying a POV that contributes a qualitative weight of appreciation to prioritization and intended impact
- Bachelor's Degree in Health Information Management (HIM) or related field preferred
- 10+ years inpatient coding experience, with progressive advancement to a supervisory or management role
- Strong supervisory/leadership skills in coding and Health Information management operations
- Confidence in their subject mastery and point of view. This individual has an opinion on most everything in the coding world, they talk the talk because they’ve walked the walk
- Deep content mastery of hospital revenue cycle management processes and billing rules
- Ability to articulate a history of success in driving quality and effectiveness in coding and related workflows
- Comprehensive knowledge of Pathophysiology, disease processes, Pharmacology and medical terminology
- Ability to effectively communicate with clinical and non-clinical staff, both verbally and in writing
- Ability to apply critical thinking skills to solve problems and make suggestions
- Experienced, confident presenter to all audiences
- Ability to work independently as well as part of an extended, cross-functional teams
- Ability to be an effective team member and display initiative and flexibility in team goal orientation in a fast pace, ever changing environment
- Travel required, predicting 25%, and should assume extends to India
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Senior Medical Coding Manager Resume Examples & Samples
- A Bachelor's degree in Nursing, Pharmacy or other Biological Science is required; advanced degree preferred
- 8 years of Medical Coding experience in a Pharmaceutical or Biotechnology company
- Clinical Data Management experience is a plus
- In-depth knowledge of MedDRA and WHO-Drug Dictionaries
- Working knowledge of Clintrial, Inform, ds-Navigator, any other data management databases/eDC systems and coding softwares
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M HIS Client Coding Manager Resume Examples & Samples
- Minimum of one (1) year of working with physician documentation
- Minimum of two (2) years of professional fee coding experience
- Minimum of two (2) years of client management experience
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Clinical Documentation & Coding Manager Resume Examples & Samples
- Oversees, supervises, and mentors all staff in conjunction with department leads to ensure adherence to departmental standards of performance
- Provides ongoing performance feedback and conducts performance evaluations to staff, using all available data and information by established review date
- Establishes and coordinates department quality improvement process through internal audits, and staff quality audits on job functions
- Manages monthly financial statements for fluctuations in variable expenses, staffing ratios and identifies trends and makes recommendations
- Implements special projects and growth plans in an efficient and timely manner
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Travel Coding Manager Resume Examples & Samples
- Supervises and performs a wide range of activities pertaining to the review and coding of inpatient and outpatient medical record information
- Establishes, implements and maintains a formalized review process for coding compliance, including a formal review (audit) process; designs and uses audit tools to monitor the accuracy of clinical coding
- Performs data quality reviews on inpatient records to validate the International Classification of Diseases Manual (ICD-10-CM, ICD-10-PCS), and other codes; verifies Diagnosis Related Group (DRG) group appropriateness; checks for missed secondary diagnoses and procedures and ensures compliance with all DRG mandates and reporting requirements; monitors Medicare and other DRG paid bulletins and manuals, and reviews the current Office of the Inspector General (OIG) work plans for DRG risk areas
- Performs data quality reviews on outpatient encounters to validate the
- ICD-10-CM, ICD-10-PCS and the Current Procedural Terminology (CPT), and the Healthcare Common Procedure Coding System (HCPCS) Level II code and modifier assignments; verifies Ambulatory Payment Classification (APC) group appropriateness; checks for missed secondary diagnoses and/or procedures; ensures compliance with all APC mandates and outpatient reporting requirements; monitors medical visit code selection against facility specific criteria for appropriateness; assists in the development of such criteria as needed
- Creates and monitors inpatient case mix reports and the top DRG’s in the facility to identify patterns, trends and variations in the facility’s frequently assigned DRG groups; investigates and evaluates potential causes for changes or problems; takes appropriate steps in collaboration with the right staff to effect resolution or explain variances
- Creates and monitors outpatient service mix reports and the leading medical visit, surgical service, significant procedure, and ancillary Ambulatory Payment Classifications (APC’s) assigned in the facility to identify patterns, trends, and variations in the facility’s frequently assigned APC groups; takes appropriate steps in collaboration with the right staff to effect resolution or explain variances
- Continuously evaluates the quality of clinical documentation to identify incomplete or inconsistent document for inpatient and/or outpatient encounters that impact the code selection and resulting APC/DRG groups and payment; brings concerns to the attention of the HIM Supervisor and/or medical staff for resolution
- Provides or arranges for training of facility healthcare professionals in the use of technical coding guidelines and practices, proper documentation techniques, medical terminology and disease as they relate to the DRG, APC and other data quality management
- Maintains knowledge of current and required coding certifications as appropriate; may perform the most technical complex and difficult coding and abstraction work
- Selects, assigns, and trains subordinate technical and clerical staff; directs, monitors and evaluates work; reviews and makes decisions regarding leave requests; initiates and implements disciplinary action as needed; assists with and promotes the recruitment and retention of qualified staff as assigned
- Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association; reports areas of concern to the Director of Health Information Management
- Assists the Director by serving as a facility representative for DRG’s and/or APC’s by attending coding and reimbursement workshops and bringing back information as appropriate; communicates any DRG/APC updates published in third-party payer newsletters, bulletins and/or provider manuals; shares information with facility staff as directed
- Stays informed about transaction code sets, Health Insurance Portability and Accountability Act (HIPPA) requirements and other future issues impacting health information management functions; keeps abreast of new technology in coding and abstracting software and other forms of automation
- Demonstrates and maintains competency in the use of computer applications, particularly the coding and abstracting software and hardware currently in use by the Health Information Management division
- Monitors unbilled account reports for outstanding services or un-coded discharges to reduce accounts receivable days for inpatients and/or outpatients; performs periodic claim form reviews to check code transfer accuracy from the abstracting software and the charge master; may serve on a charge master maintenance committee
- In partnership with appropriate personnel, recommends and implements standardized, organization-wide coding guidelines and documentation requirements; develops and implements training and educational programs for physicians and coders
- Consults with other divisions and individuals regarding data quality management
- Collects and prepares data for studies involving inpatient stays and outpatient encounters for clinical evaluation purposes; prepares and maintains a variety of complex records and reports
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Coding Manager HIM Days Resume Examples & Samples
- Under the direction of the HIM Director, the Coding Manager has the direct responsibility for all coding personnel
- Assures compliance with established coding guidelines, accurately assigns diagnosis and procedure codes to patient records
- Must be detail oriented and able to prioritize appropriately
- Collaborate with HIM Director, Business Office, Patient Access, Finance and other departments and physicians to enhance coding (IP and OP) and working DRG assignments, reduce billing delays and resolved related issues
- Serve as a resource to all coding staff and hospital for questions and on all related education
- Responsible for all DNFC functions and meeting the 4 or less day standard
- Ensures department is meeting and/or exceeding quality and productivity for the timely and efficient coding of medical records. Coding Team quality at or above 95.5%
- Adheres to all hospital and departmental policies and procedures and provides sound policy and procedure interpretation. Prepares and updates policies and procedures and job descriptions for functions supervised
- Assists with the Clinical Documentation Improvement Program
- Professionalism: Promotes a professional customer service environment in compliance with department expectations and Brookwood Performance Standards. Ensures all customer service demands and requests are met in a timely and professional manner
- Handles personnel issues, including interviewing, hiring and performance management
- Performs all orientation, evaluations, training and cross training, scheduling, conflict resolution as appropriate
- Evaluates staff regularly to ensure quality and productivity standards adherence and open communication is established. Meets with Director monthly to provide reports on productivity and quality
- Prepares monthly required statistical reports and other statistical reports as needed/requested – to include quarterly audits
- Assist with budget preparation as needed and ensures budgetary cost containment at all times. Ensures staff has supplies and equipment needed to perform duties
- Serves as chairperson or member of department and hospital committees as assigned
- Adheres fully to attendance policy requirements
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Cardiology Coding Manager Resume Examples & Samples
- Manages the Outpatient, Inpatient, and Physician professional fee coding and charge entry functions to ensure compliance to PMCC policies and procedures
- Oversees, directs, and guides coding specialists. Responsible and accountable for coding accuracy, timeliness, editing, and utilization of systems and tools used to perform coding functions
- Builds strong relationships and facilitate effective communication between hospital and physician-based Revenue Cycle and Clinical (where appropriate) operations, centralized Revenue Cycle operations (PAS, middle Revenue Cycle Operations, PFS, Customer Service), and core support departments (e.g., human resources, business support services, compliance, finance)
- Works closely with physicians to ensure that charges are being accurately and compliantly being captured, billed, and follow up on
- Manages and works with physician office staff on revenue cycle work flow improvements as needed
- Using data and reports, performs root cause analyses to identify areas where the process may not be working effectively or efficiently. Working with the entity, lead process improvement efforts in the entity or in corporate Revenue Cycle Operations to drive improvement in the overall revenue cycle process
- Proactively identifies sources of issues and communicates these to the appropriate parties. In conjunction with the Entity and corporate Revenue Cycle leadership teams, maintains ongoing issues and priority list for Entity and corporate Revenue Cycle. Completes analysis of issues for action, presents this information and implements action plans as approved by the Director of Revenue Cycle
- Analyzes Key Performance Indicator (KPI) data and coordinate Revenue Cycle analytics, utilizing all available data
- Reviews patient medical records to recommend or assign codes and modifiers for diagnoses, treatments, surgical procedures, and non-surgical procedures for professional services
- Assures industry accepted coding principles, government regulations, protocols, and third-party requirements pertaining to billing and documentation are followed
- Identifies training needs for coding staff; designs, develops, schedules, and implements training activities as needs are identified
- Conducts quality reviews to insure maintenance of industry standards of 90% accuracy for Coding and Charge Entry transactions. Identifies opportunities for efficiencies and implements as approved
- Assists with the coordination of internal and external coding compliance audits. Provides written reports to Director or Manager with audit results
- Provides accurate and appropriate answers to physician’s coding and billing questions on a timely basis
- Reviews, modifies, and recommends changes to policies and procedures to improve professional fee coding and data management
- Aligns knowledge of coding and documentation requirements, working closely with Revenue Cycle Departments
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Profee Coding Manager Resume Examples & Samples
- Coordinates work assignments of system wide coding staff and adjusts work lists to accommodate volume and schedule changes
- Maintains schedule of all remote coding staff
- Provides cost effective management of resources for the assigned work unit
- Provides interpretation of function or department policies
- Maintains coding staff employee files and tracks annual performance evaluations
- May participate in daily work load
- May perform other duties as necessary to meet company and department objectives
- Registered Health Information Technician (RHIT) or; Registered Health Information Administrator (RHIA) or; Certified Coding Specialist Professional (CCSP) or Certified Outpatient Coding (COC) ; Two plus years medical records experience with at least one year of leadership experience preferred and at least two years of technical coding experience
- Must maintain credentials through completion of established CE requirements
- Ability to manipulate and interpret data in database to support operational needs
- Communication and interpersonal skills for contact with internal and external customers to obtain and interpret a variety of information based on knowledge of departmental practices, hospital policies and programs and specific technical and regulatory knowledge
- Leadership skills such as accountability, decision-making, coaching and counseling
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Coding Manager Resume Examples & Samples
- Provides guidance and direction to subordinates, ensures their compliance to the policies and procedures, goals and objectives of the department
- Regulates the accuracy of coding and abstracting of discharged medical records
- Evaluates employee productivity and conduct audits to ensure that the existing standards are met
- Communicates with the Patient Financial Services department and superiors regarding outstanding accounts for inpatient and ambulatory surgery discharges
- Communicates and respond to physicians and other departments regarding coding and DRG issues as they pertain to coding and reimbursement
- Maintains coding guidelines for the unit to ensure coding quality and uniformity
- Ensures compliance with State, Federal and regulatory requirements
- Provides META generated reports for research projects and educational studies
- Recommends medical record/coding software modifications
- Directly supervises a staff (8) employees; Indirectly supervises a staff of 5 (total 13)
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Coding Manager Resume Examples & Samples
- Oversees job performance, attendance and quality issues of the hospital coding staff
- Interviews, hires and trains new staff
- Completes evaluations as per departmental and corporate policy
- Selects, assigns and sequences the appropriate ICD10-CM/PCS and CPT codes to patients’ current encounter of care according to established sequencing guidelines for optimal reimbursement and generation of the appropriate DRG and/or AP/APR/DRG. Abstracts inpatient records in an accurate manner according to established procedures and guidelines
- Develops, coordinates, implements and provides training on new coding programs
- Performs quality review on all hospital coders, providing feedback and education on areas identified as opportunities of improvement
- Contacts the appropriate health care provider when there is inadequate information on which to base code assignment or to clarify inconsistent, doubtful or non-specific information in a medical record by querying the responsible provider
- Provides the health care providers with feedback and education on clinical documentation practices as identified through the review process
- Participates in departmental and hospital programs for quality assessment and improvement and works with department management to improve the services provided
- Takes on other responsibilities as assigned by the Director of the HIM department
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Coding Manager Resume Examples & Samples
- Responsible for the day to day department administrative operations, monitoring that DNFB is at 1 day after suspense period
- Assigns accounts to coders as needed (high dollar, oldest) in order to maintain DNFB using available reports for distribution of accounts
- Oversight of coding functions associated with CMS billing guidelines
- Works closely with CDI staff to incorporate query processes into best coding practices
- Ensure coding quality in regards to CPT, ICD-10 CM and PCS methology, ensuring optimal quality and reimbursement within Federal and State regulations
- Establish policies and implement changes
- Coordination with other HIM operations managers, leads, and coordinators
- Review departmental procedures and evaluate the effectiveness of personnel
- Analyze denial and rejection reports and appeals whenever appropriate
- Proactively provide information, direction, and updates relevant to coding to providers
- Review patient medical records to assign codes for diagnoses, treatments, surgical procedures, and nonsurgical procedures for hospital services
- Maintains a working knowledge of CPT and ICD-10 coding principles, governmental regulations, protocols and third-party requirements pertaining to billing and documentation
- Ensures all services documented in the patient’s chart are coded with appropriate diagnoses and procedure codes. When services are not documented appropriately, seeks to attain proper documentation in a timely manner. Works with Revenue Integrity (Charging) and ancillary departments as needed for correct claim components
- Reviews records to ensure compliance with coding and documentation guidelines and governmental requirements. Escalates issues to Audit area as needed for further review
- Conducts education to physicians as needed in order to clarify documentation requirements
- Ensures maximum efficiency and reimbursement for properly documented services
- Performs other related duties as assigned or requested in a professional manner
- 5+ years of experience in a Health Information Management department
- 2+ years of management experience in acute care setting
- CCS or RHIT
- 2+ years of coding experience
- 3+ years of experience managing a coding department in a 300+ bed, Acute Care hospital facility
- Bachelor's degree in HIM (Health Information Management) or related field; sufficient experience may substitute for degree
- RHIA (Registered Health Information Administrator)
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Coding Manager Resume Examples & Samples
- Manages ongoing coding HIM support for all DHS facilities, this includes: accountability for all phases of record review, identifying areas of improvement, training and education, developing action steps for eliminating risk, prioritizing, scheduling and assisting with compiling results reporting
- Provide on going compliance monitoring of the Corporate coding policies
- Ensure necessary communication between coding personnel and coordinating with physicians and, at times, patients
- Provides guidance for implementing policies and procedures, recommends changes as appropriate, and provides relevant feedback and recommendations for process improvement to HIM Department
- Complete quarterly/monthly trending analysis of facility coding performance
- Identify and implement process improvements to improve service to facility customers
- Perform data analysis using coding review accuracy rates, DRG benchmarks, facility profiles and core coding reports
- Routinely communicate pertinent information, status and opportunities to HIM management and assist in development of tools/resources, policies and procedures, and training and education as necessary
- Responsible for the security and accuracy of the patient records the coding function maintains, and to fulfill these requirements must remain current with software and network security issues
- Serves as a key promoter of HIM and is responsible for promoting a positive attitude for the department to our customers as a service organization, continuously seeking to understand, meet and exceed their needs
- Participate in HIM project initiatives, this includes: participate in interdepartmental/multidisciplinary team meetings, committees and/or task forces
- Provide relevant guidance for customers to resolve internal and external issues
- Ensures that staffing levels and coverage is maintained at all times for timely coding of all accounts. This may involve working with contract staff, staffing companies and interim support
- Stay abreast of regulatory requirements and company compliance policies, and ensuring compliance through education
- Equivalent to an Associates Degree (2 years college)
- Minimum five (5) years HIM coding experience
- Minimum three - five (3-5) years supervisory experience
- RHIA, RHIT and/or CCS certification
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Coding Manager Resume Examples & Samples
- Ensure coding quality in regards to CPT, ICD-10 CM and PCS methodology, ensuring optimal quality and reimbursement within Federal and State regulations
- Establish policies and procedures and implements change
- Analyze denial and rejection reports and writes appeals whenever appropriate
- Ensures all services documented in the patient’s chart are coded with appropriate diagnoses and procedure codes. When services are not documented appropriately, seeks to attain proper documentation in a timely manner. Works with Revenue Integrity (Charging) and ancillary departments as needed for correct claim components, which includes resolving billing edits
- Reviews records to ensure compliance with coding and documentation guidelines and governmental requirements. Escalates issues to Audit area as needed for further review. Responsible for managing and processing rebills according to established policies and procedures
- Trains new coders, as necessary to maintain staffing
- Provides Coding assistance and education to hospital departments, which includes reviewing cases, setting up reports or running reports, and researching guidelines
- 2+ years of coding management experience in acute care setting
- 5+ years of inpatient and outpatient coding experience
- CCS
- 3+ years of experience managing a coding department in a 200+ bed Acute Care hospital facility
- RHIA (Registered Health Information Administrator) or RHIT
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Regional Coding Manager Days Resume Examples & Samples
- Assists Regional Executive Director of HIM and Coding for the EFR in the management of coding functions, which includes first level validations of NCCI and OCE edits, to assure efficiency of workflow processes to meet organizational goals
- Supervises all aspects of all inpatient, rehab, same day surgery, observation, OP in a bed, emergency room, wound care, outpatient and recurring accounts for the EFR and provides back-up assistance when necessary
- Reviews coding performance and projects for any vacancies to promote education and training in preparation for any opportunities. Encourages and educates coders for promotions in preparation for vacancies
- Coordinates with Coding Quality & Education Coordinator on appeals of all coding changes made by the PRO, RAC, or fiscal intermediary, which conflict with standard coding practices and/or hospital coding policies
- Responsible for development and monitoring of coding guidelines, including policy and procedures for the department for coding processes as part of the compliance program
- Assists in preparing educational sessions and resource materials necessary for Coders to remain abreast of coding guidelines and new technology
- Acts as liaison between PFS and ancillary departments regarding issues resulting in delay of coding processes as related to the Accounts Not Selected for Billing processes, including review and analysis of statistical reports
- Acts as liaison with ED nurse auditors regarding processing of ER codes for completion of coding processes
- Works with Coding Quality & Education Coordinators regarding education for coders as result of quality and productivity audits
- Appropriately staffs department. Assigns employees and schedules staff utilizing supervisory discretion and independent judgment. Responsible for the timely completion of biweekly time and attendance
- Conducts staff meetings with department employees on a routine basis to review progress, discuss problems, and any changes in policy and procedures. Conducts monthly virtual rounding sessions with coding staff
- Initiates and attends meetings for CDMP task force, and ANSB task force, as deemed necessary
- Attends the FHMMC Leadership meetings and Revenue Cycle Committee meetings in addition to any special invitations for coding input or direction
- Monitors and assures the timely completion of CPA work items and insures the resolution of any issues that remain incomplete for an extended period
- Performs special projects as assigned by the Director of Coding and CFOs
- Abstract reasoning required to create health information reports upon demand and troubleshoot workflow through multiple integrated computer systems
- ICD10 Diagnosis and Procedure Coding
- Educated on UHDDS coding rules and guidelines
- Computer proficiency required
- Excellent communication and written skills are preferred
- Knowledge and proficient use of Microsoft software, specifically excel
- Associate of Science Degree in Health Information Technology with RHIT registration required or an Associate of Science Degree with CCS certification required
- Five years of inpatient hospital coding experience required
- Bachelor of Science Degree in Health Information Management with RHIA registration preferred
- Minimum of two years’ previous management experience preferred
- RHIT or CCS required
- Driver’s License required
- RHIA Preferred
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HIM Coding Manager Resume Examples & Samples
- The level of knowledge normally obtained through the completion of a Bachelor's Degree in Health Information Management or a related field
- Registered Health Information Administrator or Registered Health Information Technician required
- Minimum of 5 years progressively responsible hospital based HIM operations management experience with an emphasis on coding oversight knowledge of federal and state release of information regulations, regulatory and accrediting agency standards and HIPPA required
- Previous work experience in HIM process redesign strongly preferred
- Proficiency in health information management computer systems required
- Familiarity with Microsoft Office products such as Excel, Word, and Access required
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Optum Risk Adjustment Coding Manager Resume Examples & Samples
- Under the direction of the Associate Director of Coding Quality providers leadership to and accountable for the performance of coding staff
- Strategically supports the continued development of the medical record review process and resource tools through project team involvement and leadership
- Performs quality audits on all vendor charts as well as internal coding team charts on a quarterly basis
- Ensure that established coding standards are consistently applied in all processes
- Provides input and feedback on employee performance and conducts counseling and disciplinary actions as necessary
- Responsible for ICD-10 RAPS training for Clinical Quality Analysts
- Provide day to day supervision and coordination of staffing assignment for the coding team
- Performs quality and productivity reviews on all vendor charts as well as internal coding team charts on quarterly basis
- Collaborate with doctors, coders, facility staff, and a variety of internal and external customers on a wide scope of risk adjustment education efforts
- Providers input and feedback on employee performance and conducts counseling and disciplinary actions as necessary
- Records and maintains quality and productivity metrics for coding staff
- Maintain compliance with Optum coding standards and CMS Risk Adjustment guidelines
- Drives new projects successfully
- Serves as key resource on complex and/or critical issues.- Proficient in the use of Word, Excel, Outlook Power Point
- Current Coding Certification is required for this position. UHG will recognize any of the following Coding Certifications: Certified Professional Coder (CPC) from AAPC or Registered Health Information Technician (RHIT) or Certified Coding Specialist - Physician - based (CCS - P) from AHIMA
- 5+ years of clinical and / or comparable medical records coding experience
- 2+ years of Supervisory or Management experience
- Knowledge of Medicare Risk Adjustment and Hierarchical Condition Categories: HCC
- Ability to work a flexible schedule, including evening and weekend hours and travel as necessary
- Ability to interact with multiple levels of management including, clients, vendors, and healthcare providers
- Proficient in the use of Word, Excel, Outlook, PowerPoint and the Internet
- RHIT certification
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Billing & Coding Manager Resume Examples & Samples
- Serve as coding SME including but not limited to basic E&M, specialty specific surgery coding and ICD-9/ICD-10 -CM for practices within his/her
- Must have a high school diploma or equivalent. Associate’s degree in related field preferred
- Completion of college level courses in medical coding/billing, medical terminology, anatomy and physiology, highly desirable
- Must be certified through the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC), Preferred OR Must be
- Expert working knowledge of CPT-4, ICD9, ICD-10-CM and HCPCS codes as well the National Correct Coding Initiative (NCCI) edits
- Strong understanding of coding and documentation issues facing the healthcare industry
- Remains current on reimbursement regulations and coding guidelines and keeps the market informed of changes
- Skilled in exercising initiative, judgment, problem solving and decision making
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Remote Coding Manager Resume Examples & Samples
- Coding Technical Skills – extensive regulatory coding (ICD-10-CM, ICD-10-PCS, CPT/HCPCS, MS-DRGs, APR DRGs) and associated reimbursement knowledge
- Case Mix Index Analytical Skills – ability to analyze trends in CMI and determine root cause and address as appropriate
- Leadership – leads individuals and groups toward identified outcomes, setting high performance standards and delivering quality services
- Critical Thinking – actively and skillfully conceptualizing, applying, analyzing, synthesizing or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning or communication as a guide to belief and action
- Building and Maintaining Strategic Working Relationships – develops collaborative relationships to facilitate the accomplishment of work goals. Possesses excellent interpersonal skills in building, negotiating and maintaining crucial relationships. 3 Coding Manager Updated 3/01/2017
- Building Trust – interacts with others in a way that gives them confidence in one’s intentions and those of the organization
- Effective Operational Decision Making – relating and comparing; securing relevant information and identifying key issues; committing to an action after developing alternative courses of action that take into consideration resources, constraints, and organizational values
- Adaptability – maintaining effectiveness when experiencing major changes in work tasks or the work environment; able to adapt to change in environment and/or circumstances with a positive outlook; and adjusting effectively to work within new work structures, processes, requirements, or cultures
- Initiative – independently takes prompt proactive steps towards problem resolution
- Managing Conflict – dealing effectively with others in an antagonistic situation; using appropriate interpersonal styles and methods to reduce tension or conflict between two or more people
- Energy – consistently maintaining high levels of activity or productivity; sustaining long working hours when necessary; operates with vigor, effectiveness, and determination over extended periods of time
- Stress Tolerance – maintaining stable performance under pressure or opposition; handling stress in a manner that is acceptable to others and the organization
- Planning and Organization – proactively prioritizes initiatives, effectively manages resources and keen ability to multi-task
- Communication – communicates clearly, proactively and concisely with all key stakeholders
- Customer Orientation – establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
- Work Independently – is self-supporting; not needing to rely on others to complete a job
- Quality Orientation – accomplishing tasks by considering all areas involved, no matter how small; showing concern for all aspects of the job; accurately checking processes and tasks; being watchful over a period of time
- PC Skills – demonstrates proficiency in Microsoft Office applications and others as required
- Project Management – assesses work activities and allocates resources appropriately
- Coach, Mentor and Educate – provides timely guidance and feedback to help strengthen the knowledge/skill set of others to accomplish a task or solve a problem
- Minimum 3 years health care management/leadership experience required
- Minimum 7 years recent inpatient/outpatient hospital coding experience (production, auditing and or managing) required
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Remote Coding Manager Resume Examples & Samples
- May perform coding quality audits
- May assist with resolution and improvement of revenue cycle initiatives/issues
- Experience in computerized encoding and abstracting in a Windows-based environment preferred
- Analytical ability to gather and interpret data to identify discrepancies, problems or issues, to determine compliance with regulations, policies and procedures and to apply sound judgment
- Adaptability, creative problem solving and organizational ability
