Coding Operations Lead

Role Overview

• Directly oversees and supervises day to day operations of designated Coding Department teams.
• Prioritize, assess, and re-prioritize daily workflows to ensure timely execution of Coding and meeting/exceeding goals/KPI.
• Assist with creation of front-end scrubs/edits based on coding guidelines and denial management review.
• Effectively manages the team through streamlined improvement initiatives to ensure the team is highly effective for the providers.
• Actively participates and maintain strong new hire training process and assist with policy/procedure documentation and process workflow.
• Conduct audits of team members to ensure quality initiatives are being met and exceeded.
• Identify and document trends in underpayments, denials, aging receivable that compromise the ability of the Coding team to meet established goals.
• Assists with resolution of complex claims or projects and trains team to improve follow up efforts.
• Strong analytical skills to prepare project data with external payors and partners.
• Motivate, train, evaluate, record and report team members performance and progress.
• System matter expert of all Coding functions across the team to maintain a highly efficient and productive team and to ensure process can be trained effectively.
• Assist Management in establishing weekly/monthly goals, ensure Coding team members are utilizing all resources and meeting and/or surpassing weekly/monthly KPI’s.
• Assist manager with preparing weekly and monthly RCM reporting metrics to remediate any items outside established KPI including status report of projects.
• Research and maintain understanding of policy changes across the RCM markets.
• Daily reviews of the following programs: Incoming claim/denial volumes, daily billing, rejections, evaluate clean claim rates, and team workflows.
• Assist manager in the interview process.
• Assist with preparation of team meetings focused on collaboration and process improvement.
• Assist Manager with employee performance appraisals and work with the coding team on skill development.

Requirements

• More than 5 years’ experience/Seniority with healthcare billing
• 2 or more applicable Coding Certificates (CPC, COC, CRC, CPMA, CGIC) Does not apply to data entry Lead
• Associates or Bachelor’s Degree is highly preferred but experience may be substituted for education
• Experience with a large, growing healthcare organization supporting 100 or more providers and overseeing 10+ team members
• Experience with a large Practice Management (PM) System, eCW (E Clinical Works) is a plus but not required
• 5+ experience in healthcare industry and 1+ years of supervisory experience/leading a team, in Billing/Coding roles
• Able to run open claims reports in Visiquate for coder distribution. Analyze productivity report to assure action plan and expectations are met by coding team. Responds to RCM Care Center and Internal Request smartsheet. Provides routing coder audit for quality assurance
• Utilizes Visiquate, Power BI and reconciliation reports to upload and analyze data to align all Coding benchmarks and identify support areas and coverage
• Extensive knowledge of patient registration, coding guidelines, billing, regulatory requirements, billing compliance

Benefits

• Health insurance
• 401(k) retirement plans
• Profit-Sharing
• Dental insurance
• Life insurance
• Vision insurance
• Disability insurance
• Pet insurance
• Paid time off
• 7 paid holidays