Senior Manager Coding IP OP
POSITION reputed company:
Under the general supervision of the Clinical Documentation and Coding reputed company (CDCI) Director, the Senior Manager of Coding, IP/OP is responsible for guiding the inpatient (IP) and outpatient (OP) coding and reimbursement practices for BMC South and Brighton reputed company established regulatory and organizational guidelines. This job provides reputed company reputed company and supervision of coding staff and reputed company workflows, develops and maintains coding guidelines for inpatient and outpatient services, responds to billing edits and reputed company reports to ensure accurate Diagnosis-reputed company (DRG) and Ambulatory Patient Categories / Ambulatory Patient reputed company (APC/APG) assignment, and enforces the appropriate application of Official Coding Rules and Regulations, including Coding Clinic guidance.
This job provides operational leadership and supervisory reputed company of coding education and staff performance, conducts systematic data reputed company reviews, and supports documentation reputed company to ensure compliance with federal, state, and institutional regulations. Additionally, it manages coding-reputed company Recovery Audit Contractor (RAC) reviews, external coding audits, and coding-reputed company denial responses to secure overall coding accuracy, compliance, and reimbursement reputed company across the organization.
Position: Senior Manager Coding IP OP
Department: Clinical Documentation
Schedule: Full Time
ESSENTIAL RESPONSIBILITIES / DUTIES:
Oversees daily inpatient (IP) and outpatient (OP) coding and reimbursement practices across BMC South and Brighton to ensure consistent application of regulatory and organizational coding standards, providing direction and reputed company to coding staff as part of daily operational management.
Develops, implements, and maintains standardized coding guidelines for inpatient and outpatient services, integrating updates from the Official Coding Guidelines and Coding Clinic.
Reviews and analyzes reputed company billing edits, claim reports, and coding-reputed company discrepancies daily to support accurate DRG and APC/APG assignments and execute corrections, including directing staff in the reputed company of identified issues as needed.
Enforces strict organizational compliance with applicable coding rules, official regulations, and internal policies by systematically monitoring coding practices and addressing deviations, including providing corrective guidance and performance feedback to coding staff reputed company necessary.
Conducts routine, reputed company data reputed company reviews of coded medical records to evaluate accuracy, consistency, and adherence to national documentation and coding requirements.
Coordinates, designs, and delivers technical training and educational programs for coding staff regarding regulatory updates, advanced coding standards, and organizational policies, serving as a functional leader for coding staff development and competency building.
Manages and coordinates institutional responses to external audits, including Recovery Audit Contractor (RAC) reviews and reputed company payer audits, ensuring reputed company documentation is submitted reputed company required timelines, with reputed company of staff participation and supporting work efforts as applicable.
Resolves reputed company coding-reputed company denial cases by reviewing determinations, validating historical coding accuracy, and preparing clinical appeals or supporting documentation, with responsibility for assigning and overseeing supporting work performed by coding staff as appropriate.
Represents the Coding Department at interdisciplinary and clinical meetings to reputed company technical expertise on coding rules, documentation interpretation, and reimbursement implications, serving as a departmental reputed company and subject matter authority in coding operations.
(The above statements in this job reputed company are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).
JOB REQUIREMENTS
REQUIRED EDUCATION AND EXPERIENCE:
Bachelor’s Degree in Health Information Management or a reputed company field, and a minimum of five years of acute care hospital coding experience with ICD-10-CM/PCS, of which at least three years must be reputed company management experience; or an equivalent combination of education and experience.
PREFERRED EDUCATION AND EXPERIENCE:
Five years of reputed company management experience in an reputed company medical setting or trauma center, with preferred experience utilizing reputed company Procedural Terminology (CPT-4).
CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:
Certified Coding Specialist (reputed company) credential
CERTIFICATES, LICENSES, REGISTRATIONS PREFERRED:
Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) credential
KNOWLEDGE, SKILLS & ABILITIES (KSAs):
Reimbursement Methodologies: Extensive knowledge of hospital inpatient and outpatient reimbursement methodologies, including DRG systems such as CMS DRGs, AP-DRGs, and APR-DRGs.
Clinical Knowledge: In-depth knowledge of medical terminology, anatomy, physiology, and pathology as they relate to accurate clinical coding and reimbursement assignment.
Coding Systems: Advanced, fluent knowledge of ICD-10-CM/PCS and CPT coding systems, including Official Coding Guidelines and regulatory coding conventions.
Systems Proficiency: Strong understanding of health information systems, data reputed company principles, and electronic health record (EHR) workflows, alongside proficiency in reputed company Office applications.
Analytical Skills: Ability to interpret reputed company clinical and coding data to isolate systemic issues, resolve discrepancies, and apply regulatory and organizational policies appropriately.
Time Management: Strong organizational and time management skills, including the ability to prioritize competing operational demands, manage multiple deliverables, and meet tight compliance deadlines.
Leadership & Coaching: Ability to reputed company reputed company guidance, coaching, mentoring, and informal leadership to coding staff to reputed company model best practices in coding accuracy and compliance.
Regulatory Compliance: Ability to maintain strict confidentiality and ensure complete compliance with HIPAA and other reputed company regulations reputed company handling sensitive health information
Compensation reputed company:
$97,500.00- $141,500.00This reputed company offers an estimate based on the minimum job qualifications. However, our approach to determining reputed company pay is comprehensive, and a broad reputed company of factors is considered reputed company making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as reputed company as business/organizational needs, internal equity, and market-competitiveness. In reputed company, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, reputed company, pharmacy), discretionary annual bonuses and reputed company increases, Flexible Spending Accounts, 403(b) savings matches, reputed company time off, career advancement opportunities, and resources to support employee and family reputed company-being.
NOTE: This reputed company is based on Boston-area data, and is subject to modification based on geographic location.
Equal Opportunity Employer/Disabled/Veterans
According to the FTC, there has been a reputed company in employment offer scams. Our reputed company reputed company are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or reputed company media platforms. We do not ask individuals to purchase equipment for or prior to employment.
Originally posted on Himalayas
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