Medical Coding Manager

Memorial Hospital Of Carbon County; Rawlins (WY); On-site; USD 90,000 - 120,000; Full time

Job summary

Memorial Hospital Of Carbon County in Rawlins, WY is seeking a senior CDI/Revenue Cycle Manager to oversee coding specialists and CAH coders, ensuring accurate documentation and compliant reimbursement. You will partner with department leaders to improve coding processes, review EHR data for accuracy, provide education to providers, and ensure alignment with CMS guidelines and regulatory requirements.

This role emphasizes leadership, process improvement, and ongoing staff development in a busy

Qualifications

• High school diploma or equivalent; experience in revenue cycle.
• Five years of Critical Access hospital coding experience.
• Knowledge of CMS, CMS guidelines, and regulatory coding guidelines.

Responsibilities

• Manage Medical Coding Specialist and CAH Coder positions, including hiring, mentoring, and annual reviews.
• Improve processes and education related to coding and the revenue cycle with department leaders.
• Review EHR data and clinical documentation to ensure accuracy for coding.
• Collaborate with physicians to improve documentation quality and DRG assignment.
• Monitor CDI queries for compliance and timely responses.
• Provide monthly coder education meetings and oversee CDM updates.

Skills

Revenue cycle experience

Coding guidelines

Education

High school diploma or equivalent

Revenue cycle education/certification

Job description

Job Details:

Job Location: Memorial Hospital of Carbon County - Rawlins, WY 82301, Position Type: Full Time,

Qualifications: Position Requirements

Licensure/Certification/Registration: Experience with Revenue Cyle and Professional and Technical coding guideline.

Education: High school diploma or equivalent and graduate of or extensive experience in revenue cycle.

Experience: Compliance with Medicare Critical Access Hospital reimbursement guidelines. Five years of Critical Access coding, CDM updates, NCCI edits and complete understanding of Professional and Technical components, inpatient facility coding, ancillary coding. Reimbursement guidelines and compliance with CMS and other regulatory requirements.

Principle Duties and Responsibilities:

• Manage Medical Coding Specialist and CAH Coder positions to include Hiring, Time management, mentoring, educating, payroll approvals, annual reviews and disciplinary actions.
• Work with department leaders to improve processes and education regarding subjects related to coding and the revenue cycle.
• Review, analyze and interpret the E.H.R. and provide support for coders.
• Review clinical documentation to ensure accuracy and completeness for coding and compliance
• Assist with the Query providers for clarification or additional documentation to support accurate coding and DRG assignment if initial response is not provided.
• Collaborate with physicians and clinical staff to improve documentation quality and specificity
• Analyze coding reports, for opportunities to capture severity of illness, risk of mortality, and appropriate reimbursement
• Monitor and track CDI queries and responses for compliance and reporting purposes
• Assist with educating providers on documentation best practices and coding requirements
• Ensure adherence to regulatory guidelines and hospital policies related to documentation and coding
• Participate in audits and quality improvement initiatives related to CDI
• Ensure Productivity and Qualify of all coders is addressed monthly and reports are available for review. Address all educational needs and remain updated regarding the constant changes related to regulations and industry trends and outlooks, in order to proactively response to those changes.
• Actively participate in any revenue cycle changes within the facility.
• Review and implement improvement projects
• Design and implement Productivity standards and Qualify standards.
• Provide monthly education meetings for all coders, to include, but not limited to trends with a provider, technical coding issues, Order set pricing discrepancy.
• Responsible for the oversight of updates to CDM.