38,935 Coding Manager jobs in the United States

Coding Manager

75215 Park Cities, Texas Scottish Rite for Children

Posted 3 days ago

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Job Description

Our patients are our number one priority! We're committed to giving children back their childhood!

Job Posting Title:
Coding Manager

Location:
Dallas - Hospital

Additional Posting Details:

Primary Location Address

Hybrid

Monday - Friday

8am - 5pm

Job Description:

Job Description

  • Establishes and maintains an efficient and timely coding, auditing, and education process while ensuring the accuracy and quality of coded and abstracted information for all patient types across physician services and campuses of Scottish Rite Childrens Hospital. Provides ongoing education to coders, physicians, and other clinical staff. Serves in a management and advisory capacity to the Coding staff and in an educational and advisory capacity to the clinical staff and physicians as it relates to documentation, coding, and regulatory compliance. Works effectively with leadership and coding team to increase and improve coding services.
Duties/Responsibilities
  • Manages the daily operations of the Hospital Coding Department to promote steady workflow and data integrity.
  • Manages the daily operations of the Physician Practice Coding Department to promote steady workflow and data integrity.
  • Collaborate with and educate physicians on coding and documentation guidelines.
  • Research coding questions and provide coder feedback - Ensures timely correction of coding errors and edits.
  • Ensures coding audits are performed concurrently and that the areas being audited are updated in conjunction with the department policies.
  • Oversees the monitoring of the aging and DNB accounts to ensure that accounts are coded in a timely manner and that performance is within established coding quality and productivity benchmarks.
  • Conducts regular audits and coordinates monitoring of coding accuracy, productivity, and available clinical documentation.
  • Ensures that audit reports are reviewed, accurate, and corrective action plans implemented.
  • Provides feedback and assists in facilitating and/or coordinating focused educational programs regarding coding and clinical documentation best practices to Coding and clinical staff as needed.
  • Interviews, hires and trains employees; plans, assigns and direct workflow, appraises employee performance; addresses complaints and resolving problems; and proactively manages production and quality control efforts.
  • Conducts trend analysis to identify patterns and variations in coding/documentation practices and case mix index.
  • Identifies process improvement opportunities within the Coding department and implements solutions.
  • Reviews claim denials and rejections pertaining to coding and medical necessity issues and implements corrective action plans as needed/required.
  • Works to provide all Coding staff with annual, quarterly, semi-annual ICD-10-CM/PCS and/or CPT code changes.
  • Maintains all coding information and provides updated manuals, resources, and other coding material.
  • Maintain strong communication with Director(s) and business partners in reporting of unbilled activities related to coding.
  • Mentors team members to encourage personal and professional growth.
  • Encourages ongoing skill development by providing opportunities for continued education.
  • Applies critical thinking, problem solving and change management skills to lead the process and team in identifying and resolving systemic issues.
  • Develop, implement and monitor policies and procedures, guidelines, and coding compliance plan for coding.
Required Skills/Abilities
  • Proven knowledge base in complete and accurate clinical documentation in all healthcare settings and for all healthcare disciplines.
  • Demonstrated knowledge base and experience in acute care hospital and physician/clinic coding and billing practices.
  • Demonstrated knowledge of the conventions, rules, and guidelines for multiple classification systems, including ICD-10 diagnosis and procedures, CPT and Evaluation & Management coding systems.
  • Knowledge of multiple reimbursement systems (e.g., Medicare Severity-Diagnosis Related Groups (MS-DRG) and Ambulatory Payment Classification (APC)
  • Knowledge of clinical documentation improvement methodologies.
  • Ability to establish rapport with physicians and other healthcare practitioners.
  • Must have strong analytical and critical thinking skills to support problem solving and associated change management.
  • Prior use of 3M encoder and Epic software is preferred.
Education
  • Associates degree in Health Information Management/Health Information Technology, or related healthcare field, or 3 years of managerial experience in Health Information Management or Coding
Certification
  • Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician (CCS-P), or Certified Professional Coder (CPC).
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Coding Manager-Onsite

58722 Burlington, North Dakota K.A. Recruiting

Posted 3 days ago

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Job Description

Coding Manager Needed in North Dakota
  • Onsite M-F Day Shift
  • POSITION SUMMARY
    • Responsible for management and oversight of all professional (provider) coding operations throughout Trinity Health and Trinity Medical Group. Manages departmental coding compliance programs to ensure coding quality, coding ethics and regulatory guidelines are met. Provides leadership for education, change management, quality and productivity goals. This position is responsible for revenue cycle initiatives and goals to ensure the professional fee coding at Trinity Health meets established objectives and exceeds in work performance initiatives to support provider unbilled processes. Responsible for ensuring procedural compliance with regulatory and professional standards governing coding and billing.
For more information please send your resume to !
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Client Success/ Coding Manager

75215 Park Cities, Texas Calpion/Plutus Health

Posted 3 days ago

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Job Description

About Plutus Health Inc.:

Plutus Health Inc. is a leading provider of Revenue Cycle Management (RCM) services, certified in SOC2 compliance and recognized among the Inc. 5000 fastest-growing private companies. We specialize in revenue cycle optimization for hospitals, physician groups, and healthcare organizations across various specialties. Our commitment to innovation and excellence has earned us recognition as a 2024 EY Entrepreneur Of The Year finalist and one of the top 100 fastest-growing companies in Dallas.

Job Description:

We are seeking an experienced Client Success/ Coding Manager with expertise in medical coding, auditing, and compliance to oversee client relationships, coding operations, and revenue cycle optimization. This role requires a deep understanding of CPT, ICD-10, HCPCS, payer policies, and denial management, ensuring that clients receive best-in-class coding services and compliance support.

The ideal candidate will have a strong background in medical coding, compliance audits, RCM workflow optimization, and payer regulations, along with exceptional client relationship management skills.

Key Responsibilities:

Client Success & Relationship Management:

  • Serve as the primary point of contact for clients, ensuring smooth communication and resolution of coding-related concerns.
  • Develop and implement client engagement strategies to maximize satisfaction, retention, and revenue growth.
  • Conduct Quarterly Business Reviews (QBRs) and compliance audits to drive process improvements.
  • Identify upsell and cross-sell opportunities within client accounts to expand coding service offerings.
Medical Coding & Compliance Oversight:
  • Ensure adherence to ICD-10, CPT, HCPCS, and payer-specific guidelines across multiple specialties.
  • Conduct coding audits, documentation reviews, and risk assessments to improve coding accuracy and compliance.
  • Monitor denial trends, coding discrepancies, and revenue leakage, implementing corrective actions as needed.
  • Stay up to date with Medicare, Medicaid, and commercial payer regulations, ensuring regulatory compliance.
  • Provide training and education to clients and internal teams on evolving coding guidelines and best practices.
Revenue Cycle & Denial Management:
  • Optimize coding workflows, ensuring efficient charge capture and clean claim submission.
  • Collaborate with billing, AR, and denial management teams to reduce denials, enhance revenue recovery, and improve coding accuracy.
  • Track key performance indicators (KPIs) such as clean claim rates, denial rates, coding accuracy, and compliance scores.
  • Drive coding automation initiatives to improve operational efficiency and minimize manual errors.
Cross-Functional Collaboration & Leadership:
  • Work closely with operations, compliance, and technology teams to refine and enhance coding service offerings.
  • Lead and mentor onshore and offshore coding teams, ensuring high performance and adherence to compliance standards.
  • Partner with business development teams to support client onboarding, process improvement initiatives, and contract renewals.
  • Act as an RCM Subject Matter Expert (SME) in internal strategy discussions and client engagements.
Required Qualifications:
  • Bachelor's degree in Healthcare Administration, Business, or a related field (Master's preferred).
  • 7+ years of experience in medical coding, auditing, and revenue cycle management in a leadership role.
  • Certification required: CPC, CCS, or equivalent (AHIMA or AAPC certification preferred).
  • Strong understanding of payer policies, claims processing, medical necessity guidelines, and risk adjustment methodologies.
  • Experience in coding audits, denial resolution, and revenue integrity initiatives.
  • Proficiency in RCM platforms, EHR/EMR systems (Epic, Meditech, Paragon, etc.).
  • Experience managing onshore/offshore coding teams and handling multi-client engagements.
  • Strong analytical, problem-solving, and negotiation skills with the ability to translate data into actionable insights.
  • Willingness to travel as needed.
Why Join Plutus Health Inc?
  • Work for a fast-growing, innovative company recognized for excellence in healthcare.
  • Collaborate with a dynamic, supportive team that values professional development.
  • Make a meaningful impact on patient care and operational success.
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Coding Manager Langley Health Services

33585 Sumterville, Florida Thomas E Langley Medical Ctr

Posted 3 days ago

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Job Description

Overview

JOB SUMMARY: The Coding Manager is responsible for overseeing and managing coding operations within a Federally Qualified Health Center (FQHC), ensuring the accurate and compliant assignment of CPT, ICD-10, and HCPCS codes in accordance with CMS, HRSA, and payer requirements. The Coding Manager supervises the Medical Documentation Specialist, who liaises with providers to ensure clinical documentation supports accurate coding, reimbursement, and regulatory reporting, including UDS measures.

Responsibilities
  1. Provide leadership and supervision to the medical coding team, ensuring accurate and timely coding of encounters by ICD-10, CPT, and HCPCS standards and CMS, HRSA, and payer-specific guidelines.
  2. Supervise the Medical Documentation Specialist and ensure effective collaboration between providers, coders, and billers to support compliant documentation and optimal coding outcomes.
  3. Collaborate with clinical providers to enhance documentation quality and accuracy, supporting compliant billing, appropriate risk stratification, and accurate Uniform Data System (UDS) reporting.
  4. Partner with AI coding vendors to validate automated coding outputs, ensuring alignment with current coding standards and improving overall coding efficiency.
  5. Coordinate with Clinical Care Coordinators to ensure coding practices support value-based care models, risk adjustment accuracy, and timely closure of care gaps.
  6. Conduct routine internal coding audits and chart reviews to monitor accuracy, identify trends, and implement corrective actions supporting compliance and data integrity.
  7. Maintain current knowledge of federal, state, and payer coding regulations and update internal protocols and workflows to ensure compliance and operational consistency.
  8. Design and deliver ongoing training for providers and coding staff on documentation improvement, regulatory changes, and best practices for accurate and compliant coding.
  9. Monitor coding productivity, accuracy, and quality metrics; develop and implement performance improvement plans to meet departmental and organizational benchmarks.
  10. Collaborate with billing, clinical, quality, and compliance teams to enhance communication, improve documentation workflows, and ensure alignment between coding practices and organizational goals.
  11. Provide coding guidance to medical departments about specialty coding and telehealth services.


Supervisory Responsibilities

Supervises assigned coding staff, clinical documentation specialist, and related support personnel.

Qualifications
  • A high school diploma or equivalent is required.
  • Certified FQHC Coder.
  • Demonstrated proficiency in ICD-10, CPT, and HCPCS coding systems, with an in-depth understanding of current coding guidelines, CMS requirements, and payer-specific rules.
  • Familiarity with HRSA and UDS reporting requirements, including coding elements related to clinical quality measures and value-based care programs.
  • Experience with electronic health record (EHR) systems and automated coding tools, including collaboration with AI-supported coding platforms.
  • Strong leadership, communication, and analytical skills, with the ability to train, audit, and support staff to ensure compliance and accuracy.
  • Proven experience working with vendors to improve AI-driven coding decision-making, including validating outputs and implementing improvements.
  • Ability to collaborate with providers, clinical support staff, revenue cycle teams, and external partners to ensure accurate documentation and optimal coding outcomes.

To apply please email your resume to the reply link or fax to , attention Human Resources. We are an equal opportunity employer and drug-free workplace.

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Vendor Resource Management Profee Coding Manager

37247 Nashville, Tennessee Parallon

Posted 3 days ago

Job Viewed

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Job Description

Description

This position is incentive eligible.

Introduction

Do you want to join an organization that invests in you as a Vendor Resource Management Profee Coding Manager? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.

Benefits

Parallon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

  • Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
  • Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
  • Free counseling services and resources for emotional, physical and financial wellbeing
  • 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  • Employee Stock Purchase Plan with 10% off HCA Healthcare stock
  • Family support through fertility and family building benefits with Progyny and adoption assistance.
  • Referral services for child, elder and pet care, home and auto repair, event planning and more
  • Consumer discounts through Abenity and Consumer Discounts
  • Retirement readiness, rollover assistance services and preferred banking partnerships
  • Education assistance (tuition, student loan, certification support, dependent scholarships)
  • Colleague recognition program
  • Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
  • Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

You contribute to our success. Every role has an impact on our patients lives and you have the opportunity to make a difference. We are looking for a dedicated Vendor Resource Management Profee Coding Manager like you to be a part of our team.

Job Summary and Qualifications

The VRM Pro-fee Manager is responsible for assisting in the development and evolution of the overall strategy for the Companys Vendor Resource Management pro-fee coding operations. The VRM Pro-Fee Manager manages, directs and coordinates the pro-fee coding activities for the Vendors in correlation with the Central Coding Unit (CCU). The VRM Pro-Fee Manager plans, assigns and directs the coding workflow between Vendors and CCU; actively monitors employee and vendor performance; addresses complaints and resolves problems; and actively monitors production and quality control efforts. The VRM Pro-Fee Manager is responsible for preparing/monitoring forecast volumes and scheduling/coordination/queue monitoring of production coding resources to assure accounts available for coding are coded within Service Level Agreement (SLA). The VRM Pro-Fee Manager ensures Vendor inventory is monitored daily; ensures queue concerns or resource changes are communicated to CCU as needed; ensures coder productivity and daily/weekly/monthly completion volumes are tracked and monitored. The VRM Pro-Fee Manager is expected to interact with PSC/CCU Leadership as well as VRM leadership for overall collaboration in regards to Vendor activities. The VRM Pro-Fee Manager is also actively engaged in continuous process improvement activities to enhance timely claims completion, financial performance, and corporate contribution.

What you will do in this role:

  • Provides direct managerial oversight to vendors and Team Leads in management of pro-fee coding functions, work queues, work processes, and overall work responsibilities.
  • Ensures complete, accurate, timely and consistent coding, while adhering to published coding guidelines and Company policies.
  • Coaches and helps develop team members; helps resolve dysfunctional behavior and promotes teamwork within functional area(s); disciplines and counsel staff as necessary
  • Proactively manages (including corresponding communications and escalation paths) significant issues in coding, status of projects, barriers and successes
  • Selects, evaluates, trains, and provides leadership and direction to reporting staff
  • Responsible for continuous review and improvement of processes and services
  • Responsible for ensuring employee work schedules sufficiently meet business and customer needs
  • Provides guidance and oversight in retrieving, organizing and reporting data
  • Facilitates problem solving and collaboration within functional area(s)
  • Works closely with other members of the Parallon Central Coding Leadership Team in addressing issues impacting accurate/timely coding and documentation
  • Responsible for ensuring staff/vendor coding personnel compliance with documented and established workflow guidelines as it relates to adding and reassigning accounts to work queues/worklists
  • Assists in identifying and implementing process improvements to decrease costs and improve service for applicable stakeholders
  • Performs productivity monitoring and provides timely and consistent feedback to vendor and VRM pro-fee staff
  • Monitors, escalates and assists in the resolution of system issues reported by the production coders
  • Manages tracking of vendor staff and maintains accurate vendor staff list
  • Manages all month end processes by ensuring month end volumes get pulled and sent to the vendors; month end stats are sent to leadership
  • Monitors vendor coders pended accounts in production to ensure timely turnaround per contract agreement
  • Provides timely follow-up to customer escalations related to coding quality and coding process issues
  • Responds to customer requests for action plans to improve coding quality and operational process concerns
  • Promptly reports issues or trends to the appropriate member of the Parallon Leadership team, or other appropriate party
  • Maintains up-to-date knowledge of regulatory changes impacting coding requirements and ensures VRM staff are appropriately educated
  • Reviews all official data quality standards, coding guidelines, company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current
  • Prepares and hosts weekly and/or ad hoc vendor conference calls
  • Coordinates work assignments to achieve operational goals
  • Manages the onboarding process for VRM support staff
  • Establishes and maintains good working relationships with the vendors
  • Coordinates and ensures completion of training and education for VRM staff and vendor coders
  • Works with multi-disciplinary teams in addressing issues related to coding and medical record improvement (as applicable)
  • Ensures safe, ergonomic, and confidentiality compliant practices are being followed within the work environment
  • Practice and adhere to the Code of Conduct philosophy and Mission and Value Statement
  • Other duties as assigned

Qualifications:

  • Undergraduate degree required. Bachelors degree strongly preferred. Equivalent work experience may substitute education requirements.
  • Inpatient/outpatient professional fee coding experience required
  • Minimum three years experience in related area preferred with two of these years being healthcare management experience
  • Experience managing multi-specialty coders strongly preferred.
  • RHIA, RHIT and/or CCS/CPC required

Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.

HCA Healthcare has been recognized as one of the Worlds Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"

"Good people beget good people."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Vendor Resource Management Coding Manager opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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Vendor Resource Management Profee Coding Manager

37090 Lebanon, Tennessee Parallon

Posted 3 days ago

Job Viewed

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Job Description

Description

This position is incentive eligible.

Introduction

Do you want to join an organization that invests in you as a Vendor Resource Management Profee Coding Manager? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.

Benefits

Parallon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

  • Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
  • Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
  • Free counseling services and resources for emotional, physical and financial wellbeing
  • 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  • Employee Stock Purchase Plan with 10% off HCA Healthcare stock
  • Family support through fertility and family building benefits with Progyny and adoption assistance.
  • Referral services for child, elder and pet care, home and auto repair, event planning and more
  • Consumer discounts through Abenity and Consumer Discounts
  • Retirement readiness, rollover assistance services and preferred banking partnerships
  • Education assistance (tuition, student loan, certification support, dependent scholarships)
  • Colleague recognition program
  • Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
  • Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

You contribute to our success. Every role has an impact on our patients lives and you have the opportunity to make a difference. We are looking for a dedicated Vendor Resource Management Profee Coding Manager like you to be a part of our team.

Job Summary and Qualifications

The VRM Pro-fee Manager is responsible for assisting in the development and evolution of the overall strategy for the Companys Vendor Resource Management pro-fee coding operations. The VRM Pro-Fee Manager manages, directs and coordinates the pro-fee coding activities for the Vendors in correlation with the Central Coding Unit (CCU). The VRM Pro-Fee Manager plans, assigns and directs the coding workflow between Vendors and CCU; actively monitors employee and vendor performance; addresses complaints and resolves problems; and actively monitors production and quality control efforts. The VRM Pro-Fee Manager is responsible for preparing/monitoring forecast volumes and scheduling/coordination/queue monitoring of production coding resources to assure accounts available for coding are coded within Service Level Agreement (SLA). The VRM Pro-Fee Manager ensures Vendor inventory is monitored daily; ensures queue concerns or resource changes are communicated to CCU as needed; ensures coder productivity and daily/weekly/monthly completion volumes are tracked and monitored. The VRM Pro-Fee Manager is expected to interact with PSC/CCU Leadership as well as VRM leadership for overall collaboration in regards to Vendor activities. The VRM Pro-Fee Manager is also actively engaged in continuous process improvement activities to enhance timely claims completion, financial performance, and corporate contribution.

What you will do in this role:

  • Provides direct managerial oversight to vendors and Team Leads in management of pro-fee coding functions, work queues, work processes, and overall work responsibilities.
  • Ensures complete, accurate, timely and consistent coding, while adhering to published coding guidelines and Company policies.
  • Coaches and helps develop team members; helps resolve dysfunctional behavior and promotes teamwork within functional area(s); disciplines and counsel staff as necessary
  • Proactively manages (including corresponding communications and escalation paths) significant issues in coding, status of projects, barriers and successes
  • Selects, evaluates, trains, and provides leadership and direction to reporting staff
  • Responsible for continuous review and improvement of processes and services
  • Responsible for ensuring employee work schedules sufficiently meet business and customer needs
  • Provides guidance and oversight in retrieving, organizing and reporting data
  • Facilitates problem solving and collaboration within functional area(s)
  • Works closely with other members of the Parallon Central Coding Leadership Team in addressing issues impacting accurate/timely coding and documentation
  • Responsible for ensuring staff/vendor coding personnel compliance with documented and established workflow guidelines as it relates to adding and reassigning accounts to work queues/worklists
  • Assists in identifying and implementing process improvements to decrease costs and improve service for applicable stakeholders
  • Performs productivity monitoring and provides timely and consistent feedback to vendor and VRM pro-fee staff
  • Monitors, escalates and assists in the resolution of system issues reported by the production coders
  • Manages tracking of vendor staff and maintains accurate vendor staff list
  • Manages all month end processes by ensuring month end volumes get pulled and sent to the vendors; month end stats are sent to leadership
  • Monitors vendor coders pended accounts in production to ensure timely turnaround per contract agreement
  • Provides timely follow-up to customer escalations related to coding quality and coding process issues
  • Responds to customer requests for action plans to improve coding quality and operational process concerns
  • Promptly reports issues or trends to the appropriate member of the Parallon Leadership team, or other appropriate party
  • Maintains up-to-date knowledge of regulatory changes impacting coding requirements and ensures VRM staff are appropriately educated
  • Reviews all official data quality standards, coding guidelines, company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current
  • Prepares and hosts weekly and/or ad hoc vendor conference calls
  • Coordinates work assignments to achieve operational goals
  • Manages the onboarding process for VRM support staff
  • Establishes and maintains good working relationships with the vendors
  • Coordinates and ensures completion of training and education for VRM staff and vendor coders
  • Works with multi-disciplinary teams in addressing issues related to coding and medical record improvement (as applicable)
  • Ensures safe, ergonomic, and confidentiality compliant practices are being followed within the work environment
  • Practice and adhere to the Code of Conduct philosophy and Mission and Value Statement
  • Other duties as assigned

Qualifications:

  • Undergraduate degree required. Bachelors degree strongly preferred. Equivalent work experience may substitute education requirements.
  • Inpatient/outpatient professional fee coding experience required
  • Minimum three years experience in related area preferred with two of these years being healthcare management experience
  • Experience managing multi-specialty coders strongly preferred.
  • RHIA, RHIT and/or CCS/CPC required

Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.

HCA Healthcare has been recognized as one of the Worlds Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"

"Good people beget good people."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Vendor Resource Management Coding Manager opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

View Now

Vendor Resource Management Profee Coding Manager

37230 Nashville, Tennessee HCA Healthcare

Posted 16 days ago

Job Viewed

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Job Description

**Description**
This position is incentive eligible.
**Introduction**
Do you want to join an organization that invests in you as a Vendor Resource Management Profee Coding Manager? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.
**Benefits**
Parallon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
+ Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
+ Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
+ Free counseling services and resources for emotional, physical and financial wellbeing
+ 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
+ Employee Stock Purchase Plan with 10% off HCA Healthcare stock
+ Family support through fertility and family building benefits with Progyny and adoption assistance.
+ Referral services for child, elder and pet care, home and auto repair, event planning and more
+ Consumer discounts through Abenity and Consumer Discounts
+ Retirement readiness, rollover assistance services and preferred banking partnerships
+ Education assistance (tuition, student loan, certification support, dependent scholarships)
+ Colleague recognition program
+ Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
+ Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.
Learn more about Employee Benefits ( Eligibility for benefits may vary by location._**
You contribute to our success. Every role has an impact on our patients' lives and you have the opportunity to make a difference. We are looking for a dedicated Vendor Resource Management Profee Coding Manager like you to be a part of our team.
**Job Summary and Qualifications**
The VRM Pro-fee Manager is responsible for assisting in the development and evolution of the overall strategy for the Company's Vendor Resource Management pro-fee coding operations. The VRM Pro-Fee Manager manages, directs and coordinates the pro-fee coding activities for the Vendors in correlation with the Central Coding Unit (CCU). The VRM Pro-Fee Manager plans, assigns and directs the coding workflow between Vendors and CCU; actively monitors employee and vendor performance; addresses complaints and resolves problems; and actively monitors production and quality control efforts. The VRM Pro-Fee Manager is responsible for preparing/monitoring forecast volumes and scheduling/coordination/queue monitoring of production coding resources to assure accounts available for coding are coded within Service Level Agreement (SLA). The VRM Pro-Fee Manager ensures Vendor inventory is monitored daily; ensures queue concerns or resource changes are communicated to CCU as needed; ensures coder productivity and daily/weekly/monthly completion volumes are tracked and monitored. The VRM Pro-Fee Manager is expected to interact with PSC/CCU Leadership as well as VRM leadership for overall collaboration in regards to Vendor activities. The VRM Pro-Fee Manager is also actively engaged in continuous process improvement activities to enhance timely claims completion, financial performance, and corporate contribution.
**What you will do in this role:**
+ Provides direct managerial oversight to vendors and Team Leads in management of pro-fee coding functions, work queues, work processes, and overall work responsibilities.
+ Ensures complete, accurate, timely and consistent coding, while adhering to published coding guidelines and Company policies.
+ Coaches and helps develop team members; helps resolve dysfunctional behavior and promotes teamwork within functional area(s); disciplines and counsel staff as necessary
+ Proactively manages (including corresponding communications and escalation paths) significant issues in coding, status of projects, barriers and successes
+ Selects, evaluates, trains, and provides leadership and direction to reporting staff
+ Responsible for continuous review and improvement of processes and services
+ Responsible for ensuring employee work schedules sufficiently meet business and customer needs
+ Provides guidance and oversight in retrieving, organizing and reporting data
+ Facilitates problem solving and collaboration within functional area(s)
+ Works closely with other members of the Parallon Central Coding Leadership Team in addressing issues impacting accurate/timely coding and documentation
+ Responsible for ensuring staff/vendor coding personnel compliance with documented and established workflow guidelines as it relates to adding and reassigning accounts to work queues/worklists
+ Assists in identifying and implementing process improvements to decrease costs and improve service for applicable stakeholders
+ Performs productivity monitoring and provides timely and consistent feedback to vendor and VRM pro-fee staff
+ Monitors, escalates and assists in the resolution of system issues reported by the production coders
+ Manages tracking of vendor staff and maintains accurate vendor staff list
+ Manages all month end processes by ensuring month end volumes get pulled and sent to the vendors; month end stats are sent to leadership
+ Monitors vendor coders pended accounts in production to ensure timely turnaround per contract agreement
+ Provides timely follow-up to customer escalations related to coding quality and coding process issues
+ Responds to customer requests for action plans to improve coding quality and operational process concerns
+ Promptly reports issues or trends to the appropriate member of the Parallon Leadership team, or other appropriate party
+ Maintains up-to-date knowledge of regulatory changes impacting coding requirements and ensures VRM staff are appropriately educated
+ Reviews all official data quality standards, coding guidelines, company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current
+ Prepares and hosts weekly and/or ad hoc vendor conference calls
+ Coordinates work assignments to achieve operational goals
+ Manages the onboarding process for VRM support staff
+ Establishes and maintains good working relationships with the vendors
+ Coordinates and ensures completion of training and education for VRM staff and vendor coders
+ Works with multi-disciplinary teams in addressing issues related to coding and medical record improvement (as applicable)
+ Ensures safe, ergonomic, and confidentiality compliant practices are being followed within the work environment
+ Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"
+ Other duties as assigned
**Qualifications:**
+ Undergraduate degree required. Bachelor's degree strongly preferred. Equivalent work experience may substitute education requirements.
+ Inpatient/outpatient professional fee coding experience required
+ Minimum three years' experience in related area preferred with two of these years being healthcare management experience
+ Experience managing multi-specialty coders strongly preferred.
+ RHIA, RHIT and/or CCS/CPC required
**Parallon** provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.
HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
"
"Good people beget good people."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Vendor Resource Management Coding Manager opening. Qualified candidates will be contacted for interviews. **Submit your resume today to join our community of caring!**
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
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Hospital Reimbursement and Coding Manager, Full Time, Days

37955 Knoxville, Tennessee East Tennessee Children's Hospital

Posted 3 days ago

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Job Description

BASIC PURPOSE OF THE JOB

Responsible for managing the operations of the coding team to ensure that diagnoses and procedures have been accurately coded.

REPORTS TO
  • Director, Health Information Management
JOB REQUIREMENTS

Supervisory Responsibilities: YES

Number of Direct Reports: 8

Minimum Education: Associates Required; Bachelors Preferred.

Degree: Degree in Health Information Management or related field of study.

License/Certification Required: RHIA or RHIT and CCS

Minimum Work Experience: 5 years medical progressive coding experience, including 2 years of supervisory experience.

REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES
  • Thorough knowledge of medical coding using the ICD-10-CM/PCS and CPT4/HCPCS classification coding systems. Familiar with MS-DRGs.
  • Strong analytical and problem-solving skills.
  • Excellent communication and interpersonal skills.
  • Coding Encoder, preferably Solventum (formerly 3M) encoder
  • Strong computer skills.
  • Ability to organize work priorities and meet specific objectives under time constraints.
  • Ability to manage multiple tasks simultaneously.
DUTIES AND RESPONSIBILITIES
  • Manage and supervise the coding team, providing guidance, support, and training as needed.
  • Review and analyze medical records to ensure accurate and appropriate coding.
  • Monitor coding productivity and quality, implementing process improvements as necessary.
  • Stay up to date with coding guidelines, regulations, and industry changes.
  • Develop and maintain coding policies and procedures.
  • Collaborate with other departments to ensure coding accuracy and resolve coding-related issues.
  • Review and Appeal Insurance MS-DRG denials.
  • Strong computer skills.
  • Ability to organize work priorities and meet specific objectives under time constraints.
  • Ability to manage multiple tasks simultaneously.
  • Identify and address coding-related compliance issues.
  • Conduct regular audits to ensure compliance and identify areas for improvement.
  • Conduct regular coding education
  • Participate in the hiring and onboarding of new coding staff.
PHYSICAL REQUIREMENTS-Note: Reasonable accommodations may be made for individuals with disabilities to perform the essential functions of this position. (Remove those that don't apply)
  • Light lifting, pushing and pulling is required for 10-20 lbs occasionally and frequent moving of objects of less than 10 lbs is required. Frequent sitting with some walking, standing, squatting, bending and reaching is required. Keyboard/computer use and/or repetitive motions may be required.


Come work where you can make a difference everyday.
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Coding Educator Manager

22904 Charlottesville, Virginia Insight Global

Posted 3 days ago

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Job Description

Insight Global is seeking a Coding Education Manager for a large academic medical center in Virginia. The Enterprise PB Coding Manager for Coder and Provider Education is responsible for directing and managing the PB Coding education team supporting physicians, other healthcare providers, and medical coders on coding practices, documentation guidelines, and industry regulations. This position is responsible for the development of both coder and provider educational materials and standard procedures, as well as creating educational updates and programs to address any industry and regulatory changes that impact professional services documentation and coding. The manager also oversees both the coder and provider review process, ensuring documentation and coding is accurate and compliant with industry guidelines and regulations, ultimately leading to improved reimbursement and patient care.
Manage the Coding team including but not limited to: hiring, training, managing & evaluating team performance and conducting professional development plans.
Ensure that the productivity and actions of the Coding team meet and support the overall operational goals of the department and institution.
Assist Director with development of annual budget.
Design, develop and execute standard policies and procedures, and strategies targeted to improve the quality of documentation, data integrity, and overall quality of patient outcome reporting.
Develop and execute Coding process improvement projects (department and institutional wide)
Collaborate extensively with members of the health care team to provide data and solution development processes.
Inform and educate coding staff or other departments (as needed) of regulatory (CMS/Medicaid) and 3rd party payors and implements policy/guidelines to ensure compliance with changes.
Responsible for serving as the primary point of contact for interactions with internal and external customers to CBO, primary decision maker regarding collection activities with third party insurance and guarantors.
Assures compliance with state law mandates on collections associated with the Medical Centers status as an agency of the Commonwealth.
All inquiries responded to in an efficient, accurate, and timely manner. This includes driving improvement in customer satisfaction, employee development and retention, as well as, overall operational efficiencies are maximized.
Identifying areas for improvement applicable to Revenue Cycle performance within all or one facility included in the CBO.
Accountable for Key Performance Indicators (KPIs) for assigned area(s).
Assists team members with working a client's account as needed, including but not limited to denials, rejections, claim files issues, and review codes.
Identifies trends affecting the CBOs A/R and facilities specific metrics; collaborates with the operational team to ensure the overall health of the assigned facilities.
Assists with team development, including on-going mentoring and training
Pursues continuing education of applicable software and hardware as necessary
Keeps current on payment trends and coding changes as well as payer requirement changes.
Participates in departmental and other meetings as requested
Assists with creating procedures/process documentation.
Communicates all A/R issues, including enhancement requests, defects, and inquiries, to internal stake holders.
Build and maintain strategic relationships with external and internal customers.
Develop reputation as an industry expert and trusted advisor on revenue cycle and management processes for given specialty areas of focus.

We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form . The EEOC "Know Your Rights" Poster is available here .

To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: .

Required Skills & Experience

MINIMUM REQUIREMENTS
Education: Bachelors Degree required, or obtained within 4 years, or 15 years academic healthcare experience in lieu of Bachelor degree.
Experience: 7 years of management and/or supervisory experience in healthcare or similar customer-oriented business.
Licensure: Certification as Certified Professional Coder (CPC, CCS-P), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC), Certified Coding Specialist (CCS), or Certified Coding Specialist Physician-Based (CCS-P) required. Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) preferred.

Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.

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Coding Educator Manager

22905 Charlottesville, Virginia Insight Global

Posted 16 days ago

Job Viewed

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Job Description

Job Description
Insight Global is seeking a Coding Education Manager for a large academic medical center in Virginia. The Enterprise PB Coding Manager for Coder and Provider Education is responsible for directing and managing the PB Coding education team supporting physicians, other healthcare providers, and medical coders on coding practices, documentation guidelines, and industry regulations. This position is responsible for the development of both coder and provider educational materials and standard procedures, as well as creating educational updates and programs to address any industry and regulatory changes that impact professional services documentation and coding. The manager also oversees both the coder and provider review process, ensuring documentation and coding is accurate and compliant with industry guidelines and regulations, ultimately leading to improved reimbursement and patient care.
Manage the Coding team including but not limited to: hiring, training, managing & evaluating team performance and conducting professional development plans.
Ensure that the productivity and actions of the Coding team meet and support the overall operational goals of the department and institution.
Assist Director with development of annual budget.
Design, develop and execute standard policies and procedures, and strategies targeted to improve the quality of documentation, data integrity, and overall quality of patient outcome reporting.
Develop and execute Coding process improvement projects (department and institutional wide)
Collaborate extensively with members of the health care team to provide data and solution development processes.
Inform and educate coding staff or other departments (as needed) of regulatory (CMS/Medicaid) and 3rd party payors and implements policy/guidelines to ensure compliance with changes.
Responsible for serving as the primary point of contact for interactions with internal and external customers to CBO, primary decision maker regarding collection activities with third party insurance and guarantors.
Assures compliance with state law mandates on collections associated with the Medical Centers status as an agency of the Commonwealth.
All inquiries responded to in an efficient, accurate, and timely manner. This includes driving improvement in customer satisfaction, employee development and retention, as well as, overall operational efficiencies are maximized.
Identifying areas for improvement applicable to Revenue Cycle performance within all or one facility included in the CBO.
Accountable for Key Performance Indicators (KPIs) for assigned area(s).
Assists team members with working a client's account as needed, including but not limited to denials, rejections, claim files issues, and review codes.
Identifies trends affecting the CBOs A/R and facilities specific metrics; collaborates with the operational team to ensure the overall health of the assigned facilities.
Assists with team development, including on-going mentoring and training
Pursues continuing education of applicable software and hardware as necessary
Keeps current on payment trends and coding changes as well as payer requirement changes.
Participates in departmental and other meetings as requested
Assists with creating procedures/process documentation.
Communicates all A/R issues, including enhancement requests, defects, and inquiries, to internal stake holders.
Build and maintain strategic relationships with external and internal customers.
Develop reputation as an industry expert and trusted advisor on revenue cycle and management processes for given specialty areas of focus.
We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form ( . The EEOC "Know Your Rights" Poster is available here ( .
To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: .
Skills and Requirements
MINIMUM REQUIREMENTS
Education: Bachelors Degree required, or obtained within 4 years, or 15 years academic healthcare experience in lieu of Bachelor degree.
Experience: 7 years of management and/or supervisory experience in healthcare or similar customer-oriented business.
Licensure: Certification as Certified Professional Coder (CPC, CCS-P), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC), Certified Coding Specialist (CCS), or Certified Coding Specialist Physician-Based (CCS-P) required. Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) preferred.
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