[Remote] Manager Professional Billing Coding Operations - Remote

Note: The job is a remote job and is open to candidates in USA. Boston Medical Center (BMC) is a leading provider of trauma and emergency services in New England, dedicated to community-based care and improving public health. They are seeking a Manager for Professional Billing Coding Operations to oversee coding operations, validate coding accuracy, and provide training and feedback to coding staff. The role involves managing a team of certified professional coders and ensuring compliance with coding regulations and guidelines.ResponsibilitiesReviews patient medical records and abstracts medical data that identifies all diagnoses and proceduresCodes diagnoses, procedures, and appropriate modifiers from the medical record documentation using ICD-10-CM, CPT4/HCPCS classification systemsRefers to a computerized encoding system, written coding aids and other reference materials to ensure accurate coding for billingSequences diagnoses, procedures and complications by following ICD-10-CM, CPT-4, and the Uniform Hospital Discharge Data Set (UHDDS); adheres to the Official Guidelines for Coding and Reporting, Coding Clinic guidelines and other regulatory guidelines as appropriateConsults with appropriate medical staff to clarify medical record informationMaintains productivity standards set forth in Departmental Policies and proceduresServes as contact for professional billing coders regarding missing/incomplete information to allow for accurate billing in a timely mannerMaintains knowledge of coding and professional skills, including maintaining yearly coding credentials through attendance at in-service programs, conferences, workshops, review of current literature and other educational programsAssists in orienting new personnel in department coding proceduresMonitors all coding ques to ensure productivity is being kept on targetPerforms other duties as neededReview and respond to coding questionsEnsure billed service is being accurately codedPerform random chart auditsPerform analysis of benchmarking profilesProvide continual coding updatesResearch coding issues that ariseCodes diagnoses and procedures from the medical record using ICD-10-CM and CPT-4/HCPCS classification systemsSequences diagnoses, procedures and complications by following ICD-10-CM, Medicare, Medicaid, and other fiscal intermediary guidelinesReviews charts for documentation and signatureResponsible for the day-to-day management of the PB Coding Operations TeamDuties include managing, developing and mentoring a group of certified professional codersOther responsibilities include interviewing, orientation, training and preparing evaluations; responsible for hiring, terminating and disciplining personnel as necessaryEstablishes staffing scheduling and assigns workloads and projects in accordance with appropriate volume increases and decreasesAssists with coding all professional claims under the direction of the PB Coding Operations TeamConducts quality reviews to validate code selection is compliant with established coding guidelinesEvaluates documentation for incomplete or inconsistent documentation in the record which impacts code assignmentInitiates queries when necessary and monitors responsesProvides training to healthcare professionals, coders, and Revenue Cycle staff in ICD, CPT, HCPCS Level II coding guidelines, proper documentation guidelines and other information related to codingDevelops long term strategies for improving efficiencies and increasing coding team’s productivity through use of central coding conventions and classification systems, influencing and educating the coding team as well as all revenue cycle stake holdersReports on accuracy of coding and abstractingResponsible for the tracking and response for coding accountabilities from internal and external sources. This would include RAC coding reviews as well as other payer reviewsTracks overtime, absenteeism, hours worked, leaves and vacation/sick time for assigned staffReviews and approves timesheets to PayrollMaintains knowledge of ICD-10 and CPT classifications and coding of diagnoses and proceduresParticipates in coding and reimbursement meetingsFollows established hospital infection control and safety proceduresMaintains professional skills and knowledge of coding through attendance at in-service programs, conferences, workshops and other educational programs and by review of current literatureShares knowledge and learning experiences to staffPerforms other related duties as requiredSkillsBachelor's degree or equivalent combination of formal education and experienceCPC – Certified Professional CoderMust have at least five years of experience in coding; experience must include education/mentoring/trainingMinimum of five years acute care hospital experience coding with ICD-10-CM and CPT-4Minimum of three years management experience required; five years preferredPrior experience working claim edits and denialsExcellent command of the ICD-10-CM and CPT4/HCPCS coding conventions, E&M codingWork also requires concepts of human anatomy, physiology and pathologyExcellent skill in providing hands-on education to PB Coding Operations staff based on audit finding and needStrong knowledge of health records, computerized billing and charging systems, Microsoft applications, data integrity, and processing techniques requiredExcellent organizational skills, including ability to multi-task, prioritize essential tasks, follow-through and meet timelinesAbility to work with accuracy and attention to detailAbility to solve problems appropriately using job knowledge and current policies/proceduresAbility to work cooperatively with members of the healthcare delivery team and staffAbility to handle frequent interruptions and adapt to changes in workload and work schedule and to respond quickly to urgent requestsMust be able to maintain strict confidentiality of all personal/health sensitive information and ensure compliance of HIPAA rules and regulationsMust possess extensive knowledge of hospital inpatient and outpatient reimbursement methodologiesStrong knowledge of health records, computer systems, Microsoft applications, data integrity, and processing techniques requiredAbility to mentor, guide and motivate direct reports through demonstration of best practices and leading by exampleMust possess extensive knowledge of payer claim edits and payer denialsWork requires in-depth knowledge of medical terminology, ICD-10-CM and CPT-4 Coding conventions (including E&M coding), CMS National Coverage Determinations and various other applicable coding regulations and lawMinimum of five years acute care hospital experience coding with ICD-10-CM and CPT-4, academic medical setting or trauma center preferredFive years management experience preferredBenefitsBenefits (medical, dental, vision, pharmacy)Discretionary annual bonuses and merit increasesFlexible Spending Accounts403(b) savings matchesPaid time offCareer advancement opportunitiesResources to support employee and family well-beingCompany OverviewBoston Medical Center (BMC) is a 511-bed, equity-led academic medical center and a proud member of the Boston Medical Center Health System. It was founded in 1996, and is headquartered in Boston, Massachusetts, USA, with a workforce of 5001-10000 employees. Its website is http://www.bmc.org/.