Healthcare Coding Ops Manager - Quality & Audits

Duke Careers; Durham (NC); On-site; USD 110,000 - 150,000; Full time

Job summary

Duke Health is seeking a Manager for Coding Operations within the Patient Revenue Management Organization (PRMO) in Durham, NC. This role oversees coding operations, directs audits, and drives compliant coding and billing for hospital and professional services.

Responsibilities include leading audits, guiding policy development, and coordinating with directors and peers to implement coding standards. Requires RHIA/RHIT and 6+ years healthcare coding leadership experience; a CCS/CPC is a plus.

Qualifications

• BS Health Information Management, Health Informatics, Health Administration, Finance or related field.
• Master’s degree in Business Administration or Health Administration is preferred.
• Six years of experience in the healthcare industry is required, two of the six years are supervising or coordinating coding activities.
• Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT). Certified Coding Specialist (CCS) or Certified Professional C coder (CPC) is a bonus.

Responsibilities

• Oversee Quality/Focused Audits for all PRMO Coding teams- PB and HB.
• Act as contact and coordinator for organization auditing needs.
• Identify areas for improvement and recommend solutions where education is needed for accurate coding and billing for both Hospital and Professional areas.
• Provide direction for department; Ensure TAT are met, QC of auditor QA, Ensure departmental integration, develop operational policies, procedures, standards and expectations, provide clear opportunities to meet or exceed objectives.
• Assist with policy and procedure maintenance for coding and auditing functions.
• Read and interpret LCD, NCD and other payer regulations and guidelines as related to coverage of services.
• Interviewing, hiring, training employees, planning, assigning, and directing workflows, employee performance evaluation, proactively manage production and quality controls, resolving problems.
• Collaborate with other managers to ensure consistent implementation of coding policies, procedures and practice; maintain strong communications with director and peer managers.
• Any/All other duties assigned by director

Skills

Coding knowledge ICD-10-CM, CPT

Regulatory/compliance

Leadership / team management

Education

BS Health Information Management / Health Informatics

MBA or Health Administration preferred

Job description

Duke Health is seeking a Manager for Coding Operations within the Patient Revenue Management Organization (PRMO) in Durham, NC. This role oversees coding operations, directs audits, and drives compliant coding and billing for hospital and professional services.

Responsibilities include leading audits, guiding policy development, and coordinating with directors and peers to implement coding standards. Requires RHIA/RHIT and 6+ years healthcare coding leadership experience; a CCS/CPC is a plus.