University of Rochester Manager, Coding Operations - 214856 in Rochester, New York
Manager, Coding Operations
Medical Faculty Group
Full Time 40 hours Grade 055 URMFG Business Office
8 AM-4:30 PM
The Manager for Coding Operations is responsible for working across the professional fee organization, managing all professional fee coding abstraction and pre-bill coding edit claims resolution functions and develops strategies and recommendations to improve coding acuity, quality and productivity across all departments. Functions include, but are not limited to: provider documentation review, diagnosis code and procedural code abstraction and coding edit resolution and edit trend identification. Provides periodic written reports and analyses to Associate Director and/or Revenue Cycle Advisors to clearly present results of operations and the status of receivables. The Manager is required to have demonstrated advanced knowledge and understanding of all aspects of coding operations, including principles of staff management/supervision, office workflows, some billing and collection operations, including compliance requirements as well as payer credentialing, contracting and reimbursement practices. The Manager for Coding Operations reports directly to the Associate Director of Coding and Charge Capture.
With general direction of the Associate Director of Coding and Charge Capture and reasonable latitude for initiative and judgment:
Drives revenue cycle results by effectively managing all pre-bill coding abstraction and claims edit resolution and charge review activities on pending claims for all URMFG physician services within established guidelines and production standards. Manages staff actions to resolve operational deficiencies and ensures staff adhere to established policies and procedures. Ensures that all regulatory requirements are met, and that coding is being performed in a compliant manner.
Monitors standard organizational metrics and utilizes data from all sources to create reports to meet the needs of all internal and external customers. Uses knowledge and experience to analyze detailed operational and financial data to identify coding acuity, coding abstraction and prebill coding edit problems, underlying root causes, and other related issues in regular reporting to the Associate Director. Monitors effectiveness of coding efforts and works with Associate Director to develop and implements strategies to improve acuity and productivity across all payors and URMFG departments. Implements additional coding edits based on identified preventable denial insights to prevent future rejections or delays in payment.
Manages the activities of coding employees under own supervision. Recruits, hires, trains, evaluates, and perform disciplinary actions as necessary following department and University guidelines. Constructs and monitors development plans and fosters functional unit employee engagement through focused team-building efforts, surveys and follow-up action plans.
Monitors and assesses current operations to identify opportunities for performance and process improvements and provides a high level of problem solving to support continual change management; recommend ideas to the Associate Director; implements approved changes and ensures that staff receive the training to ensure their understanding of quality/performance improvement initiatives.
Reports regularly to the Associate Director of Coding and Charge Capture regarding performance in the assigned area. Provides assistance and support to the Associate Director by supporting various initiatives impacting URMFG coding operations. Assists in implementation of operations improvement measures.
Keeps current on relevant areas of knowledge and acts as a resource to staff. Interprets and ensures compliance with regulatory standards and requirements; keeps abreast of regulatory requirements, professional standards and competitive industry practices, as well as organizational initiatives with potential to impact current operations; monitors impact on existing activities to maintain service levels and work quality.
May perform other duties as assigned.
Bachelors Degree and 5 years of related relevant experience; or equivalent combination of education and/or experience
Demonstrated organizational and problem-solving skills
Effective written and verbal communication skills
Strong working knowledge of the professional billing software applications
Active medical coding credential with AHIMA as RHIT, RHIA, CCS, CCS-P, or AAPC certified as CPC. High level, in-depth coding knowledge and experience with CPT/HCPCS and ICD-10-CM.
5 years billing office experience, at the management level
How To Apply
All applicants must apply online.
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