Director, Coding

Axia Women's Health; Voorhees Township (NJ); On-site; USD 150,000 - 180,000; Full time

Job summary

Axia Women's Health in the United States is seeking a Director of Coding to lead the coding and auditing functions across our expansive network. You will shape policies, drive compliant processes, and partner with providers, centers, and vendors to maximize quality and revenue.

The role requires deep expertise in physician billing, CMS guidelines, and leadership to educate teams, monitor KPIs, and ensure adherence to federal and state regulations within Axia’s Compliance Program.

Qualifications

• Bachelor’s degree or higher preferred or equivalent 8-10 years relevant experience.
• Minimum 5 years’ experience in billing/coding management.
• CPC through AAPC or CCS-P through AHIMA required.
• Demonstrated excellent Microsoft Excel skills.

Responsibilities

• Develops and oversees an effective coding function within the organization that provides the ideal service to our providers, ensuring best practices, efficiencies, quality outcomes and maximized revenue.
• Ensures external coding vendor operates efficiently and effectively including staffing, processes and supporting systems.
• Works with Manager of Coding and the Axia Compliance Officer and other coding professionals to design and streamline coding and compliance processes.
• Ensures professional translation and communication of audit findings to educate providers and care centers to ensure compliance with applicable rules/regulations and Axia Compliance Program.
• Communicates and trains care centers on documentation rules and requirements.
• Keeps abreast of CMS rules and guidelines and communicates changes to coding and auditing team.
• Establishes and manages key performance indicator (KPI) reporting for the coding team. Reviews KPIs daily and take an active role in making appropriate adjustments to ensure goals are met.
• Analyzes reports to determine status of outstanding AR, denials, and unbilled claims related to coding operations and works to resolve issues. Identify denial trends to effectively manage future denials
• At the direction of the Axia Compliance Officer, researches and analyzes compliance issues utilizing various publications including extensive use of the internet, the Federal Register and other industry publications.
• Delivers timely reports to leadership, initiates, and communicates the resolution of issues and timely responses to questions and concerns.
• Partners with and maintain positive relationships with internal customers, including physicians, advanced practice providers, care center managers, RCM, regional operations, and third-party coding/billing vendor.
• Analyzes and addresses staff performance and conduct in a timely and professional manner, offering counseling, correction, and discipline as appropriate. Performs periodic reviews to mentor and gives constructive performance feedback.
• Monitors and adheres to applicable Federal, State, and Local laws and regulations, Axia’s Integrity and Compliance Program and Code of Conduct, as well as other policies and procedures.

Skills

Physician billing

Revenue cycle management

CMS guidelines

Education & training

Value Based Care

Leadership

Communication

MS Office & EMRs

Education

Bachelor's degree

CPC or CCS-P certification

5-10 years billing/coding management

Tools

MS Excel

EMRs

Job description

• Pay or shift range: $150,000 USD to $180,000 USD The estimated range is the budgeted amount for this position. Final offers are based on various factors, including skill set, experience, location, qualifications and other job-related reasons.

Description

AxiaWomen's Health is the nation’s largest community-based, integrated women's health network in the country serving women throughoutNew Jersey,Pennsylvania,Indiana, andKentucky. At its core, Axia Women’s Health is a community of over 400 providers across nearly 150 locations committed to providing a more caring, connected, and progressive health care experience for women. Its rapidly growing network spans OB/GYN care, breast health, high-risk pregnancy care, urogynecology care, behavioral health, and fertility. Together, Axia Women's Health puts women first by delivering the personalized care needed for women to lead healthier, happier lives. Axia Women’s Health has been recognized as the #1 Physician Practice for Women’s Health by Castle Connolly and certified as a Great Place to Work for five consecutive years. Learn more atwww.axiawh.com .

The Director, Coding leads the function of coding/auditing for Axia Women’s Health. The Director is responsible for mapping the policies and processes of coding in compliance with all applicable rules and regulations and the Axia Compliance Program.

Essential Functions:

• Develops and oversees an effective coding function within the organization that provides the ideal service to our providers, ensuring best practices, efficiencies, quality outcomes and maximized revenue.
• Ensures external coding vendor operates efficiently and effectively including staffing, processes and supporting systems.
• Works with Manager of Coding and the Axia Compliance Officer and other coding professionals to design and streamline coding and compliance processes.
• Ensures professional translation and communication of audit findings to educate providers and care centers to ensure compliance with applicable rules/regulations and Axia Compliance Program.
• Communicates and trains care centers on documentation rules and requirements.
• Keeps abreast of CMS rules and guidelines and communicates changes to coding and auditing team.
• Establishes and manages key performance indicator (KPI) reporting for the coding team. Reviews KPIs daily and take an active role in making appropriate adjustments to ensure goals are met.
• Analyzes reports to determine status of outstanding AR, denials, and unbilled claims related to coding operations and works to resolve issues. Identify denial trends to effectively manage future denials
• At the direction of the Axia Compliance Officer, researches and analyzes compliance issues utilizing various publications including extensive use of the internet, the Federal Register and other industry publications.
• Delivers timely reports to leadership, initiates, and communicates the resolution of issues and timely responses to questions and concerns.
• Partners with and maintain positive relationships with internal customers, including physicians, advanced practice providers, care center managers, RCM, regional operations, and third-party coding/billing vendor.
• Analyzes and addresses staff performance and conduct in a timely and professional manner, offering counseling, correction, and discipline as appropriate. Performs periodic reviews to mentor and gives constructive performance feedback.
• Monitors and adheres to applicable Federal, State, and Local laws and regulations, Axia’s Integrity and Compliance Program and Code of Conduct, as well as other policies and procedures.

Supervisory Responsibilities:

• Oversees coding personnel

Qualities & Skills

• Expert on physician billing with an in-depth knowledge of revenue cycle management process, medical coding, and compliance.
• Firm grasp on coding guidelines and CMS guidelines, rules, and regulations.
• The ability to investigate compliance rules.
• The ability to break down rules and requirements to educate coders, physicians, advanced practice providers and care center personnel.
• Understand Value Based Care and Bundled codes.
• Strong leadership and ability to delegate and provide direction.
• Exceptional verbal, interpersonal, and written communication skills; ability to present ideas in a business-friendly and user-friendly way.
• Computer proficiency, including MS Office and EMRs.

Education & Experience

• Bachelor’s degree or higher preferred or equivalent 8-10 years relevant experience required.
• Minimum 5 years’ experience in billing/coding management.
• CPC through AAPC or CCS-P through AHIMA required.
• Demonstrated excellent Microsoft Excel skills.

At Axia Women’s Health, we’re passionate about creating a community where our colleagues and patients feel empowered to be their full, authentic selves. We welcome all individuals – without regards to gender, race, ethnicity, ability, or sexual orientation – and proudly celebrate our individual experiences and differences.

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification form upon hire. Applicants must be currently authorized to work in the United States on a full-time basis.

Qualifications

Education

Required

Bachelors or better.

Experience

Required

5-10 years:

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.