Medical Coding Manager

At CareHive Health, we rely on powerfully insightful data to ensure the delivery of our excellent healthcare services. We are seeking an experienced and certified medical coding professional to join our team. Our ideal coder will have a thorough knowledge of anatomy and medical terminology along with a natural curiosity to learn and understand our business as well as an analytical mind. We will rely on you to ask questions, connect the dots and uncover information that may be difficult to find - all with the end goal of ensuring an appropriate and smooth billing process by abiding with the standard protocols for medical coding.

Objectives

• Manage the coding workflow and ensure timely and high-quality coding of diagnoses and procedures using ICD-10, CPT-4, HCPCS, and HCPC coding classification systems to meet billing system requirements.
• Work closely with physicians, clinicians, technicians, insurance companies, provider groups and other integral parties to uncover and discuss coding analysis results.
• Develop, modify and execute company policies and procedures that affect immediate operations and may have organization-wide impact.
• Analyze issues where understanding situations or data requires and in-depth knowledge of organizational objectives.
• Implement strategic policies, while selecting methods and evaluation criteria or obtaining accurate results.
• Research and make recommendations to executive management regarding new coding trends and policies (i.e. telehealth, virtual first care, care coordination and navigation).

Responsibilities

• Retrieve and collect information from various resources for reporting.
• Analyze medical malpractice and denied claims by identify issues, events, diagnoses and procedures that resulted in those actions.
• Prepare summaries of medical procedures and assign the appropriate codes that apply.
• Review claims to formulate a synopsis of facts and collaborate with external claims examiners regarding the synopsis as needed.
• Make corrections to draft reports sent for physician review and submit approved reports to management in a timely fashion.
• Key member and driver of the Revenue Cycle team.
• Creates and manages coding workflows.
• Trains physicians and clinical staff on appropriate coding.
• Works with EHR config team on template development and structured data design.

Qualifications

• Bachelor's degree in health information systems or business.
• Certification as a CPC for medical practices (current certification required).
• 5+ years of medical coding in a multi-specialty practice.
• Experience with the care team concept and how to code for a care team.
• Telehealth coding experience and full understanding of coding changes/updates caused by COVID-19.
• Proven experience in administrative medical information management and computer applications.
• Ability to learn and use new EHR and other software systems quickly.