Manager, Medical Coding - Sign-on Bonus

Candidates must live in Ohio permanently. This position is eligible for remote/onsite hybrid work arrangement after completion of a 90-day introductory period.

$5,000 Sign-on Bonus

POSITION SUMMARY

Collaborates with operational team to ensure the proper policies, processes, and procedures are in place for:

charge entry and coding

payer medical policy pre-authorization guidelines

surgical price estimates and pre-collection

RESPONSIBILITIES AND ACCOUNTABILITIES

Department:

Maintain proper metrics reporting and analysis is completed to ensure:

timely completion of notes by physicians

timely completion of all encounters from a coding perspective

completing internal to-dos from other departments within Orthopedic One

timely completion of pre-authorization of surgical procedures including patient estimates

Retain a working knowledge of technology applications used in revenue cycle including but not limited to EMR, coding, denials, clearinghouse, eligibility and analytical reporting tools to provide data driven answers

Ensure timely, accurate claims are submitted to payers based on the appropriate level of patient services provided including completion of key internal information needed for physician compensation.

Develop and present educational materials across both the Patient Accounts division and operations including physicians/advanced providers to ensure accurate claims coding processes are in place.

Confers with external consultants to ensure compliant coding and resolve coding questions.

Coordinates with Patient Accounts Director to establish necessary internal and/or external coding and quality audits.

Works closely with outpatient surgery centers and hospitals to ensure patient communication is as clear as possible.

Oversee Case Management prior authorization policies and process to ensure payer medical policy guidelines are met to ensure claims are reimbursed.

Maintain necessary operational skills and knowledge to perform staff responsibilities.

Establish schedules to ensure operational coverage at all times.

Management:

Works with HR to interview and select staff and timely completion of related documentation

With HR Support, ensures performance appraisals define and measure a high level of work performance

Completes introductory and annual performance appraisals based on observed behaviors and work outcomes supported by appropriate documentation

Works to understand how staff are motivated and balance the needs of the organization and the individual. Sets expectations and rewards staff or achieving desired performance

Initiates coaching, disciplinary action, and performance improvement planning to address violations of policy and/or poor performance

Facilitates conflict resolution with staff with support as required based on circumstances

Ensures that Orthopedic One's mission, Patients First, is part of all management decisions and interventions.

Orient and Train Staff:

Orients new staff, ensuring they know the purpose of the organization, their department and position

Ensures that employees have resources, tools, feedback, assistance and training needed to achieve desired performance including productivity and qualitative expectations.

Provides effective and timely on the job training such that performance objectives are clear, staff members have knowledge and skills necessary to perform effectively

Builds learning into work performed such that staff gains increasing understanding of how and why work is performed

Instruction and information provided to staff results in complete understanding

Educates staff on all applicable new or established policies, procedures, and expectations.

Leadership:

Supports the mission, vision, values and code of conduct, goals and objectives of Orthopedic One, in customer care, community interactions, and management responsibilities.

Proactively reviews metrics important to the department workflow including work volume, customer satisfaction measures, etc. and makes recommendations to modify schedules, staff hours/staffing levels, and workflows to maintain productivity, quality and accuracy. Communicates metrics with staff timely and in mediums that maximize understanding.

Decisions, including those pertaining to staff, reflect complete and accurate analysis of relevant issues (past practices, work history, individual and group performance, department and company needs, consistency, fairness, regulatory or legal concerns, etc.)

Responsible and accountable for budget planning and cost control in area of responsibility.

Adheres to and administers company policies and procedures consistently and fairly in all matters (Employee Handbook, P&P, Risk, etc.)

Manages time and attendance to ensure employees are paid accurately and consistently based on company practices and policies.

Maintains department schedule/calendar and provides timely response to PTO requests

Promotes and supports an environment in which leaders and staff members engage in appropriate professional development, continuing education, and lifelong learning opportunities.

Submits reports/documents to appropriate parties in a complete, accurate and timely fashion (Personnel Action Notice, expense reports, etc.)

Professional Development:

Prepares appropriately to attend and participate in company meetings or projects as assigned

Facilitates special projects or assignments at the request of management

Attends to own professional development responsibilities and encourages/plans for staff to do the same.

Teamwork:

Willingly provides coverage, volunteers assistance, and maintains workflows within department as needed without direct instruction/supervision.

Works cooperatively and refrains from participating in negative conversations.

Shares knowledge and insights with co-workers in a constructive manner.

Works to solve problems and address conflicts with appropriate person directly before involving leadership or uninvolved peers.

Is considerate of others in the work environment with regard to taking breaks or meal periods, use of computer and phone, noise level in the department, etc.

QUALIFICATIONS

Education, Experience, Certification and Licensure Requirements:

Position requires an Associate's degree in business administration or related field. The applicant must have a minimum of five years of experience working in a healthcare business office setting, along with two years of supervisory experience. The applicant must have and maintain a CPC, RHIA or equivalent certification and a minimum of 2 - 4 years of coding related experience. Previous experience with Microsoft Office Suite, EMR/Practice Management software experience required. Experience managing KPI reporting desired.

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