Job Role Summary

Coding and Revenue Cycle Manager provides training to staff in ICD, CPT, HCPCS Level II coding guidelines, proper documentation guidelines and other information related to coding and revenue cycle.  

Associated Job Duties

• Responsible for meeting with coders and reimbursement specialists for training.
• Update any new coding guidelines or changes that may be a result of an audit review.
• Assist the coding team in researching new coding guidelines.
• Conducts all annual employee development initiatives.
• Monitors daily production schedule regularly and proactively addresses any obstacles to timely completion of jobs.
• Prepares coding benchmarking and coding quality monitoring reports; monitors financial targets. 
• Providing clinical guidance, support and education to various individuals and groups in the organization
• Assist with the ongoing development, interviewing, hiring, and training coding and reimbursement staff.
• Resolve complex coding discrepancies and identify risk-based areas of coding.  
• Conduct a thorough review of the medical and dental records and ensure the most appropriate alignment with procedure codes and documentation. 
• Ensure thorough and compliant coding using ICD-PCS and CPT coding rules and guidelines, to support patient records and submission of billing for payment.
• Assist with the development and implementation of policies, procedures, standards, and initiatives.
• Supports new system implementations and system upgrades. 
• Subject matter expert of E/M facility and professional charging and coding for outpatient areas.
• Responsible for understanding the variety of health coverage programs and benefit package plans offered under Indiana Health Coverage Programs for the purposes of determining patient eligibility requirements.  
• Assist with monthly financial training of staff from various departments on the organization’s practice management system, when requested. 
• Assist with developing standard operating procedures and training manuals. 
• Establish key performance metrics and other reporting tools for revenue cycle management.
• Other duties as assigned.  

Qualifications

• Bachelor’s or Associate’s Degree in Health Information Management, Business Management, Healthcare Administration preferred. 
• Demonstrated 3 to 5 years of related experience in a leadership role.  
• Medical Terminology, Anatomy, Coding guidelines, HCPCS, ICD Coding.
• Integrity, discretion, and respect for confidentiality and privacy.
• Knowledge of Microsoft Office products.

Licenses/Certifications Required

• Certified Professional Coder (CPC), AAPC or AHIMA medical coding certification preferred.
• Valid Indiana driver’s license.

Knowledge, Skills & Abilities

• Excellent interpersonal and organizational skills to hire, train and manage employees.
• Attention to detail to maintain patient records proficiently and to check that insurance information has been entered accurately.  
• Strong leadership, project management and communication skills.
• Knowledge of medical coding procedures.
• Capable of handling multifaceted tasks. 
• Flexible, adaptable with the ability to meet deadlines.
• Identify opportunities for improved performance.
• Strong organizational skills and ability to create a system to follow up on pending issues.  
• DIRECT SUPERVISION:
• Directly supervises Reimbursement Specialists, Coders, Reimbursement Clerk