Coding Manager (Remote) (22-22-303)
Company: The Stamford Hospital
Posted on: November 24, 2022
Fully Remote Position
Responsible for all processes relating to professional coding,
including documentation, edit and denial resolution, auditing and
provider education. Ensures optimal use of resources to achieve
departmental goals for productivity and Revenue Cycle goals.
Determines workflow priorities and effective methodologies to
complete tasks. Generates both routine and ad-hoc reports, and
serves as a senior resource to staff. Oversees staff training,
management, and professional development of those employees falling
under the auspices of this position. reports to the Director of
Revenue Cycle- Mid Cycle.
MAJOR ACCOUNTABILITIES / CRITICAL RESPONSIBILITIES:
* Responsible for the oversight of daily operations relating to
assigned departmental functions. This oversight includes the
monitoring of quality, the assurance of productivity, the
determination of priorities, and the management of workflow - all
of which ensures the optimal utilization of resources as well as
the satisfaction of agreed-upon goals.
* Supervises the training, daily workflow, and productivity of the
Professional Coding Department. Encourages staff members to adhere
to organizational standards as well as to expand competencies.
* In collaboration with the professional coders, the system's
Compliance Department, and any external auditing partners,
administers the system's "professional" audit program by providing
remedial and ongoing education to providers focused on identified
* Performs internal retrospective, concurrent, or prospective
medical chart audits to assure that CPT codes billed are
appropriate and supported by documentation in the patient record,
and that all coding/documentation combinations are compliant with
Federal and State regulations.
* Works with the medical group's coders and Coding Educator, the
system's Compliance Department, and any external auditing partners
in support of new provider onboarding and orientation for Stamford
Health physicians and non-physician practitioners. Provides
documentation and coding education. Provides input on template
development as needed.
* Interprets progress notes, operative reports, discharge
summaries, and charge documents to determine services provided and
accurately assign CPT and ICD coding to these services.
* Reviews and resolves pre-claim coding and reimbursement-related
inquiries as part of the charge capture/claim creation process.
Consults medical record documentation, queries providers/staff, and
applies correct coding, payer coverage and/or practice policies to
resolve edits and ensure timely, compliant submission of
* Assesses and resolves coding and reimbursement-related denials as
part of the denial resolution process. Consults medical record
documentation, queries providers/staff, and applies correct coding,
payer coverage and/or practice policies to resolve denials and
ensure timely, compliant submission of claims.
* Provides guidance to staff in reconciling coding-related edits
and denials based on medical record documentation, correct coding
initiatives, and payer coverage.
* Analyzes data, identifies issues, reaches conclusions, and
proposes strategies for resolution of complex reimbursement
* Provides coding expertise and training for providers and support
* Works in collaboration with other coding and reimbursement staff
to research payer policies that may affect the practice's clinical
and billing operations. Assists in the development of procedure
manuals related to coding and billing compliance.
* Promotes continuous review and education of documentation
standards to optimize coding and charge capture.
* Works with all key stakeholders of the revenue cycle to leverage
the system's patient management tools to facilitate accurate,
comprehensive, and compliant charge capture.
* Utilizes the electronic health record and other health
information applications throughout the system to their fullest and
most appropriate extent.
* Assists as needed with the assembly and review of records
required for a variety of internal and external audits.
* Leads the development, implementation, maintenance and monitoring
of policies and procedures related to coding and documentation.
* Remains informed regarding current coding regulations, payer
policies, and professional standards and, in turn, effectively
applies this knowledge.
* Acts as the system administrator regarding EHR/PM maintenance and
support for direct reports.
* Demonstrates knowledge of the age-related differences and needs
of patients in appropriate, specific populations from neonate
through adulthood and applies them to practice. Demonstrates
cultural sensitivity in all interactions with
* Bachelor's Degree in Accounting, Healthcare Administration or
* CPC certification required.
* 5+ years of professional billing experience, including extensive
automated billing experience, using industry-accepted software
(Epic, ECW, Meditech, etc.).
* 3+ years of outpatient, surgical coding experience, or
progressive growth in coding-related positions with surgical
* 3+ years of supervisory experience.
* Strong comprehension of CPT, ICD-10 and HCPCS coding.
* We are committed to building an inclusive workplace that values
diversity and inclusion and reflects the diversity of the community
and patients we serve.
Keywords: The Stamford Hospital, Stamford , Coding Manager (Remote) (22-22-303), Executive , Stamford, Connecticut
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