Job Details

Coding Manager

Greenway Admin Open Door Community Health Centers (ODCHC) relies on billing for services rendered and generated revenue for a significant portion of its operating budget. ODCHC is committed to proper billing procedures, documentation, and review in compliance with federal and state laws and regulations and private payor requirements. The Coding Manager is responsible for implementing clinical documentation improvement and coding compliance activities and supervises codes to ensure timely and appropriate billing of all provider encounters.

Compensation Range: $74,880.00-$86,954.40

Hmong and Spanish speakers who successfully pass a language exam will receive an additional .75 hourly differential to their wage.

Essential Duties and Responsibilities: These essential responsibilities are performed within the context of collaboration and coordination with ODCHC's Finance Department.

• Supervises Pre-Accounts Receivable processing of incoming encounters for: charge capture; accurate coding; and, timely processing of provider encounters.
• Interacts with medical, dental and behavioral health clinicians, nurses, other clinical staff, codes, billers and other associated staff regarding documentation and coding compliance, policies and procedures to clarify non-compliant documentation and coding.
• Monitors pivot reports from coder work queues to identify opportunities for clinical documentation improvement and coding compliance activities.
• Reviews Null Fee in work queues for coding accuracy and/or code reassignment and pricing needs.
• Reviews paper charge sheets for coding accuracy, code descriptions and associated fees as well as needed revisions and updates.
• Audits Charge Review Billers and Coders to assure processing and coding accuracy.
• Identify Practice Management system issues and coordinate improvements with internal personnel and external vendors.
• Reviews applications and participates in interviews and selection process for hiring new Coders.
• Maintains up-to-date orientation and training materials and provides staff with training as appropriate.
• Mentors coder trainees and coders as necessary and coordinates external continuing education and certification activities.
• Coordinates review, implementation and training related to ad hoc and annual code updates.
• Adherence to ODCHC policies and protocols.
• Other related duties as identified, assigned and required by Chief Financial Officer.

Qualifications and Expectations: The successful candidate will possess experience and skills spanning a variety areas:

• Excellent interpersonal skills and ability to establish constructive working relationships within the ODCHC Finance Department, with providers and other clinical staff and with outside agencies as appropriate;
• Strong research abilities to identify existing, changed and proposed clinical documentation and coding requirements;
• Ability to read, analyze and discuss complex documents;
• Ability to prepare routine reports and correspondence;
• Ability to supervise others and delegate appropriately.
• Computer and computer application skills sufficient to accurately and efficiently use databases, spreadsheets, practice management and electronic health records systems, auditing and word processing software.
• Reliable means of transportation to travel throughout ODCHC service area and to meetings outside of the area as necessary, including an insurable driving record and California Driver's License as necessary as well as the ability to travel to regional and national meetings.
• Adherence to ODCHC policies and protocols.

Education and Experience:

• High school diploma or GED.
• At least two years of related experience and training in clinical documentation improvement, coding, medical billing and/or auditing.
• Prior experience of a similar nature in a community health center or other medical environment.

Certificates, Licenses, and Skills:

• Coding Certification (COC, CPC or CCS preferred).

Supervisory Responsibilities: The Coding Manager supervises Charge Review Billers and Coders. The Coding Manager has the responsibility to organize training for these employees as well as providing these employees with coaching, mentoring and performance evaluation. Works in collaboration with supervisor and ODCHC Human Resources Department as necessary to address necessary corrective, improvement and reinforcement activities.

Supervision and Support: The Coding Manager reports directly to the Chief Financial Officer. Significant collaboration with other members of the Finance Department is required.

Physical Requirements: This is largely an office-based position. The physical requirements described are representative of those needed to successfully perform the essential duties of the position. Reasonable accommodation will be made to allow otherwise qualified candidates to perform these functions.

• Ability to communicate via telephone, video, and/or in-person.
• Vision adequate to read documents, computer screens, forms.
• Ability to remain stationary for extended periods of time.
• Ability to lift, carry, or otherwise move up to 25 pounds.
• Ability to use keyboard and view computer screens for extended periods of time.
• Ability to travel locally and long-distance.
• Ability to move around offices and clinics as needed.