ESSENTIAL DUTIES AND RESPONSIBILITIES
- Oversees the daily operations of the coding unit including workload and staffing, hiring, disciplining, performance appraisals, training, and monitoring quality of work.
- Develops long‑range and short‑term goals, objectives, plans, and programs and ensures they are implemented.
- Assists in planning, developing, and controlling the budget, including staffing costs, capital equipment, and operations of the coding unit.
- Evaluates the impact of innovations and changes in programs, policies, and procedures for the coding unit.
- Designs and implements systems and methods to improve data accessibility.
- Identifies, assesses, and resolves problems.
- Prepares administrative reports.
- Oversees and monitors the coding compliance program.
- Develops and coordinates educational and training programs regarding elements of the coding compliance program such as appropriate documentation and accurate coding to all appropriate staff.
- Ensures the appropriate dissemination and communication of regulatory, policy, and guideline changes.
- Conducts and oversees coding audit efforts and coordinates monitoring of coding accuracy and documentation adequacy.
- Reports noncompliance issues detected through auditing and monitoring, the nature of corrective action plans, and the results of follow‑up audits.
- Conducts trend analyses to identify patterns and variations in coding practices.
- Reviews claim denials and rejections pertaining to coding and medical necessity issues and, when necessary, implements corrective action plans to prevent similar denials and rejections from recurring.
REQUIRED EXPERTISE & QUALIFICATIONS
- Life Science graduation or any equivalent graduation with Anatomy/Physiology as main subjects.
- Master’s degree in business administration preferred.
- 10–12 years of overall coding experience, out of which a minimum five years in team handling of a team size ranging between 250 and 600 team members.
- Any one of the following coding certifications: CPC, COC, CRC, CPCP from AAPC, CCS, CCSP, CCA from AHIMA.
- Excellent communication skills, both verbal and written.
- Strong managerial, leadership, analytical and interpersonal skills.
- Outstanding organizational skills.
- Hands‑on experience in generating reports using MS Office Excel, Word and MS PowerPoint.
PHYSICAL DEMANDS
Regular eye‑hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6–8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Members must be able to lift and move material weighing up to 20 lbs. Team Members may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.