Job description

**Remote Job Opportunity, but must live in New York, New Jersey, or Connecticut**

Outpatient Medical Center, affiliated with Top Ranked Magnet Hospital is seeking a Medical Coding & Billing Manager to join our growing healthcare team!

• Job Type: Full-Time
• Job Title: Medical Coding & Billing Manager
• Location: Remote MUST live in NY, CT, or NJ
• Salary: $90,000 - $110,000 (DOE)
• Benefits: Medical, Dental, Viison, 401k, Tuition Reimbursement, Vacation, (4 wks.), PTO, Sick Days, etc.!!

JOB DESCRIPTION:

Responsible for all processes relating to professional coding, including documentation, edit and denial resolution, auditing, and provider education. Ensures optimal use of resources to achieve departmental goals for productivity and Revenue Cycle goals. Determines workflow priorities and effective methodologies to complete tasks. Generates both routine and ad-hoc reports and serves as a senior resource to staff. Oversees staff training, management, and professional development of those employees falling under the auspices of this position. reports to the Director of Revenue Cycle- Mid Cycle.

- Will have seven people apart of the Medical Coding & Billing team directly reporting/under this Manager position.

QUALIFICATIONS:

• Bachelor’s Degree in Accounting, Healthcare Administration or equivalent (Required)
• CPC certification (Required)
• 5+ years of professional billing experience, including extensive automated billing experience, using industry-accepted software (Epic, ECW, Meditech, etc.)
• 3+ years of outpatient, surgical coding experience, or progressive growth in coding-related positions with surgical components.
• 3+ years of supervisory experience
• Strong comprehension of CPT, ICD-10 and HCPCS coding

MAJOR ACCOUNTABILITIES / CRITICAL RESPONSIBILITIES:

• Responsible for the oversight of daily operations relating to assigned departmental functions. This oversight includes the monitoring of quality, the assurance of productivity, the determination of priorities, and the management of workflow – all of which ensures the optimal utilization of resources as well as the satisfaction of agreed-upon goals.
• Supervises the training, daily workflow, and productivity of the Professional Coding Department. Encourages staff members to adhere to organizational standards as well as to expand competencies.
• In collaboration with the professional coders, the system’s Compliance Department, and any external auditing partners, administers the system’s “professional” audit program by providing remedial and ongoing education to providers focused on identified documentation discrepancies.
• Performs internal retrospective, concurrent, or prospective medical chart audits to assure that CPT codes billed are appropriate and supported by documentation in the patient record, and that all coding/documentation combinations are compliant with Federal and State regulations.
• Works with the medical group’s coders and Coding Educator, the system’s Compliance Department, and any external auditing partners in support of new provider onboarding and orientation for physicians and non-physician practitioners. Provides documentation and coding education. Provides input on template development as needed.
• Interprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT and ICD coding to these services.
• Reviews and resolves pre-claim coding and reimbursement-related inquiries as part of the charge capture/claim creation process. Consults medical record documentation, queries providers/staff, and applies correct coding, payer coverage and/or practice policies to resolve edits and ensure timely, compliant submission of claims.
• Assesses and resolves coding and reimbursement-related denials as part of the denial resolution process. Consults medical record documentation, queries providers/staff, and applies correct coding, payer coverage and/or practice policies to resolve denials and ensure timely, compliant submission of claims.
• Provides guidance to staff in reconciling coding-related edits and denials based on medical record documentation, correct coding initiatives, and payer coverage.
• Analyzes data, identifies issues, reaches conclusions, and proposes strategies for resolution of complex reimbursement issues.
• Provides coding expertise and training for providers and support staff.
• Works in collaboration with other coding and reimbursement staff to research payer policies that may affect the practice’s clinical and billing operations. Assists in the development of procedure manuals related to coding and billing compliance.
• Promotes continuous review and education of documentation standards to optimize coding and charge capture.
• Works with all key stakeholders of the revenue cycle to leverage the system’s patient management tools to facilitate accurate, comprehensive, and compliant charge capture.
• Utilizes the electronic health record and other health information applications throughout the system to their fullest and most appropriate extent.
• Assists as needed with the assembly and review of records required for a variety of internal and external audits.
• Leads the development, implementation, maintenance and monitoring of policies and procedures related to coding and documentation.
• Remains informed regarding current coding regulations, payer policies, and professional standards and, in turn, effectively applies this knowledge.
• Acts as the system administrator regarding EHR/PM maintenance and support for direct reports.
• Demonstrates knowledge of the age-related differences and needs of patients in appropriate, specific populations from neonate through adulthood and applies them to practice. Demonstrates cultural sensitivity in all interactions with patients/families.

Job Type: Full-time

Pay: $90,000.00 - $110,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Flexible spending account
• Health insurance
• Paid time off
• Tuition reimbursement

Schedule:

• Monday to Friday

Ability to commute/relocate:

• Greenwich, CT: Reliably commute or planning to relocate before starting work (Required)

Education:

• Bachelor's (Preferred)

Experience:

• Medical Billing & Coding: 5 years (Preferred)
• Management: 3 years (Preferred)

License/Certification:

• CPC (Required)

Work Location: In person

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