Manager Medical Coding

About the position

The Manager, Medical Coding in Payment Integrity leads a team responsible for reviewing clinical information from various medical records to ensure appropriate procedural terminology and medical codes are billed. This role involves applying advanced technical knowledge to solve moderately complex problems, confirming appropriate diagnosis-related group (DRG) assignments, and collaborating across departments to enhance operational efficiency. The position requires strong leadership skills, data analysis capabilities, and a commitment to improving consumer experiences.

Responsibilities
? Lead a team that reviews clinical information and advises on appropriate procedural terminology and medical codes.
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? Confirm appropriate diagnosis related group (DRG) assignments.
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? Analyze, enter, and manipulate databases.
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? Respond to or clarify internal requests for medical information.
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? Make decisions related to resources, approach, and tactical operations for departmental projects.
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? Conduct briefings and area meetings, maintaining frequent contact with other managers across the department.

Requirements
? A minimum of an Associate's Degree.
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? 5 or more years of experience in medical auditing & coding with a focus on MS-DRG & APR-DRG.
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? 2 or more years of management experience in a highly matrixed operational setting.
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? RHIA, RHIT and/or CCS Certification.
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? Experience with data analysis tools such as Power BI.
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? Demonstrated experience with cross departmental collaboration.
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? Experienced leading meetings and presenting material to broad audiences.
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? Comprehensive knowledge of Microsoft Office Programs Word, PowerPoint, and Excel.
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? Ability to handle multiple priorities.
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? Capacity to maintain confidentiality.
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? Excellent communication skills both written and verbal.

Nice-to-haves
? 6 or more years of work experience related to claims with an understanding of claims lifecycles/healthcare revenue cycle management.
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? Experience leading projects and/or processes.
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? Experience in Financial Recovery.
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? Experience with systems such as CAS, MTV, CISpro and CIS.
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? Current or recent experience in provider relations and/or provider engagement.
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? Experience in a fast-paced, metric-driven operational setting.
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? Prior experience working with offshore vendors and/or leading a team of offshore associates.

Benefits
? Medical, dental and vision benefits
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? 401(k) retirement savings plan
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? Paid time off including company and personal holidays
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? Volunteer time off
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? Paid parental and caregiver leave
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? Short-term and long-term disability
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? Life insurance
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? Bonus incentive plan based on performance

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