Remote Coding Manager: Lead, Audit & Quality

Cape Cod Healthcare Inc; Hyannis (MA); Remote; USD 100,000 - 120,000; Full time

Job summary

Cape Cod Healthcare seeks a seasoned Manager of Professional Medical Coding (Remote) to lead the coding function, audits, and quality initiatives. You will supervise staff and vendors, ensure compliance with internal policies and governing agencies, and partner with HIM/Coding leadership to optimize documentation and reimbursement.

You will collaborate with physicians, practice managers, and MACC leadership to drive high-quality coding and timely issue resolution, while monitoring KPIs and

Qualifications

• Bachelor’s degree required or equivalent combination of education and experience. Master’s degree preferred.
• Current CCS (AHIMA Certified Coding Specialist) or CPC (AAPC Certified Professional Coder) required.
• Minimum of five years of previous progressive experience in multiple specialties of Professional Coding including experience in auditing and/or management.
• Possess strong working knowledge of medical terminology, anatomy and physiology, reimbursement requirements.
• One to two years supervisory experience of professional coding staff.
• Requires comprehensive understanding of Evaluation and Management Coding and Specialty coding.
• Strong knowledge of fiscal intermediary and regulatory agency regulations for coding and provider reimbursement.
• Specialty in E&M (CEMC), Certified Evaluation and Management Coder through the AAPC, or CPMA, Certified Professional Medical Auditor through the AAPC preferred.
• An understanding of the psychology of complex corporate relationships, and an ability to influence within such an environment.
• Demonstrated ability to use PC based office productivity tools (e.g. Microsoft Office) is required.
• Demonstrated goal-oriented thinking, operational and organizational skills.
• Demonstrated ability to create training materials and deliver training in area of expertise including large group presentations.
• Ability to communicate with and present to a wide variety of CCHC and external users, including senior management and physicians, as well as outside vendors and consultants.
• Ability to work under pressure and manage multiple initiatives concurrently; must be able to work independently, set own priorities and meet deadlines.

Responsibilities

• Manage compliant coding operations and ensure quality coding and abstraction of clinical data.
• Oversee staff performance and communication with practices; resolve denials and coding issues.
• Supervise professional coding staff and vendors; facilitate issue resolution.
• Coordinate with the Professional PFS dept to resolve coding/billing issues and denials.
• Monitor DNFB and other department KPIs; oversee EPIC work queues.
• Ensure supervisory staff maintains performance and monitoring processes.
• Define and monitor strategies for improving documentation.
• Develop physician education strategies with validation team and leadership.
• Report performance measures to medical staff and departments.

Skills

Leadership

Communication

Problem solving

Regulatory knowledge

Education

Bachelor’s degree

CCS or CPC certification

Master’s degree

Tools

Microsoft Office

EPIC knowledge

Job description

Cape Cod Healthcare seeks a seasoned Manager of Professional Medical Coding (Remote) to lead the coding function, audits, and quality initiatives. You will supervise staff and vendors, ensure compliance with internal policies and governing agencies, and partner with HIM/Coding leadership to optimize documentation and reimbursement.

You will collaborate with physicians, practice managers, and MACC leadership to drive high-quality coding and timely issue resolution, while monitoring KPIs and