Medical Coding Manager

Job Summary At Carewell Health, we rely on powerfully insightful data to ensure the delivery of excellent healthcare services, and we are seeking an experienced medical coding Manager to deliver this insight daily. The ideal candidate will have thorough knowledge of anatomical and medical terminology, as well as natural curiosity and an analytical mindset. As the coding Manager oversees production, quality, and consistency of the inpatient/outpatient/ED/SDS and other cases coded by the internal and external coding teams. Mines and interprets patient medical records, transcriptions, test results, and other documentation; we will rely on them to ask questions, connect the dots, and uncover information that may be difficult to find — all to ensure a smooth billing process. The medical coding manager will abide by standard protocols of the profession while using their own methods to compile the most accurate information and promote organizational growth. Essential Functions Manage high-quality, timely coding of diagnoses and procedures for inpatient and outpatient accounts, using ICD-10, CPT-4, and HCPCS classification systems. Strong knowledge of DRGs. Review coding queries, when necessary, to determine if impactful. Exceptional knowledge of ICD, CPT, and HCPCS coding guidelines. Advanced knowledge of medical terminology, anatomy, and physiology. Work closely with physicians, technicians, insurance companies, and other integral parties to uncover and discuss coding analysis results. Manage the DNFB as it relates to Coding. Correct coding related edits, issues, and questions that come from the Revenue Cycle Department. Develop and execute policies and procedures that affect immediate operations and may also have organization-wide impact. Analyze issues in which the situation or data requires in-depth knowledge of organizational objectives. Implement strategic policies by selecting methods and evaluation criteria for accurate results. Responsible for day-to-day coding operations, productivity, quality, data analytics, dashboards and reports, education, employee management and development, and clients within a specific client group or geography of clients. Perform Quality Assurance Audits on Coders. Maintain productivity benchmarks and assist in the development of productivity benchmarks. Responsible for weekly productivity log management, tracking, trending, and dashboard creation. Provide feedback and mentoring as needed to achieve productivity standards. Prioritize, schedule, assign, and monitor work to optimize operational services. Strong organizational skills and oral and written communication skills. Advanced computer skills including the use of Microsoft Office products, especially Excel, electronic mail, including experience with electronic coding systems and applications. Possess strong organizational skills and attention to detail. Ability to multi-task and meet multiple deadlines. Audit inpatient and outpatient cases on a consistent basis to ensure continued quality. Consistently review coded cases for accuracy. Other Duties Gather physician background information from various resources for reporting purposes. Analyze medical malpractice claims by identifying issues, events, diagnoses, and procedures that led to results. Prepare summaries and assign the appropriate codes. Review claims to formulate a synopsis of facts and collaborate with claims examiners as needed. Make corrections to draft reports after physician review and submit approved reports to managers in a timely fashion. Code cases as needed. Provide education and ongoing training for medical coders. Interact with claims staff, attorneys, physicians, and many other hospital-related stakeholders regarding reports. Perform related duties as required. Minimum Education/Certifications Bachelor’s degree (or equivalent) in health information systems or related field. Must have the following certification: Certified Coding Specialist (CCS). Must have one of the following certifications: Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA). Minimum Work Experience Experience: Minimum five years medical office hospital experience in coding preferred. Management or lead experience preferred. Some auditing experience preferred. Working knowledge of ICD-CM, CPT, and HCPCS coding standards and practices. Position Type/Expected Hours of Work: 8AM-4PM, 40 hours per week. Hybrid. Physical Demands Analysis: Long periods of sitting may be required. Repetitive motion of wrists required. Lifting requirements are minimal to none. Corrected vision and hearing to normal range is required.

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