Medical Coding Manager - US Remote
- Independent
- 15 - 20 years
- United States (U.S)
- 17 days ago
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Job Description
Role & responsibilities
1. Medical Coding Expertise
- Deep knowledge of:
- ICD-10-CM / ICD-10-PCS
- CPT, HCPCS Level II
- DRG (Diagnosis Related Groups)
- HCC (Hierarchical Condition Categories) for risk adjustment
- Experience with different specialties (inpatient, outpatient, ED, surgical, etc.)
2. Coding Software / Encoder Tools
- Proficiency with tools like:
- 3M Encoder
- Optum EncoderPro
- TruCode
- QuadraMed
3. Clinical Documentation Improvement (CDI)
- Understanding of how to bridge gaps between provider documentation and accurate coding
- Collaborate with CDI specialists to ensure proper reimbursement and quality metrics
4. Audit & Quality Review
- Conduct internal coding audits
- Create audit workflows and reporting
- Familiarity with OIG audit protocols, CMS guidelines
5. Compliance & Regulatory Knowledge
- In-depth knowledge of:
- HIPAA
- Medicare/Medicaid rules
- National Correct Coding Initiative (NCCI) edits
- AHIMA/AAPC coding guidelines
- Ability to update policies based on new regulatory changes
6. EHR & Practice Management Systems
- Must know how to navigate:
- Epic
- Cerner
- Athenahealth
- Meditech
- Understand integration between coding modules and billing workflows
7. Reporting & Metrics
- Use Excel, Access, or BI tools to track:
- Coding productivity
- Error rates
- Backlogs
- Denial patterns due to coding issues
8. Project & Staff Management Tools
- Familiarity with:
- Workforce management systems
- Task tracking tools (e.g., Jira, Trello, MS Project)
- Productivity benchmarking tools (especially in remote environments)
Preferred candidate profile
1. Medical Coding Expertise
- Deep knowledge of:
- ICD-10-CM / ICD-10-PCS
- CPT, HCPCS Level II
- DRG (Diagnosis Related Groups)
- HCC (Hierarchical Condition Categories) for risk adjustment
- Experience with different specialties (inpatient, outpatient, ED, surgical, etc.)
2. Coding Software / Encoder Tools
- Proficiency with tools like:
- 3M Encoder
- Optum EncoderPro
- TruCode
- QuadraMed
3. Clinical Documentation Improvement (CDI)
- Understanding of how to bridge gaps between provider documentation and accurate coding
- Collaborate with CDI specialists to ensure proper reimbursement and quality metrics
4. Audit & Quality Review
- Conduct internal coding audits
- Create audit workflows and reporting
- Familiarity with OIG audit protocols, CMS guidelines
5. Compliance & Regulatory Knowledge
- In-depth knowledge of:
- HIPAA
- Medicare/Medicaid rules
- National Correct Coding Initiative (NCCI) edits
- AHIMA/AAPC coding guidelines
- Ability to update policies based on new regulatory changes
6. EHR & Practice Management Systems
- Must know how to navigate:
- Epic
- Cerner
- Athenahealth
- Meditech
- Understand integration between coding modules and billing workflows
7. Reporting & Metrics
- Use Excel, Access, or BI tools to track:
- Coding productivity
- Error rates
- Backlogs
- Denial patterns due to coding issues
8. Project & Staff Management Tools
- Familiarity with:
- Workforce management systems
- Task tracking tools (e.g., Jira, Trello, MS Project)
- Productivity benchmarking tools (especially in remote environments)
Perks and benefits
Job Classification
Industry: Medical Services / HospitalFunctional Area / Department: Healthcare & Life Sciences,
Role Category: Health Informatics
Role: Medical Biller / Coder
Employement Type: Full time
Contact Details:
Company: IndependentLocation(s): United States (U.S)
Keyskills: EHR & Practice Management Systems Clinical Documentation Improvement Coding Software / Encoder Tools Reporting & Metrics Medical Coding Expertise Audit & Quality Review
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