Role:

The Certified Medical Coder - Manager plays a pivotal role in overseeing the accuracy and efficiency of medical coding and billing operations within a healthcare organization. This position ensures that all medical records are coded correctly according to established guidelines, facilitating proper reimbursement from insurance providers and patients. The manager will lead a team of AR billing specialists, providing training, support, and quality control to maintain compliance with healthcare regulations and payer requirements.

Minimum Qualifications:

Certified Professional Coder (CPC) or equivalent certification in medical coding. Minimum of 3 years of experience in medical coding and billing, including experience with CPT coding and healthcare reimbursement. Proven experience managing a team or leading projects within a medical coding or billing environment. Strong knowledge of Medicare, commercial insurance billing, and patient collections processes. Familiarity with healthcare regulations and compliance standards related to medical coding and billing.

Preferred Qualifications:

Bachelor's degree in Health Information Management, Healthcare Administration, or a related field. Experience with electronic health record (EHR) systems and medical billing software. Additional certifications such as Certified Coding Specialist (CCS) or Certified Medical Reimbursement Specialist (CMRS). Demonstrated success in process improvement initiatives within a healthcare revenue cycle. Strong analytical skills with experience in data reporting and financial analysis related to medical billing.

Responsibilities:

Supervise and mentor a team of billing specialists to ensure accurate and timely coding and billing processes. Review and audit medical records and coding to ensure compliance with CPT, ICD-10, and other relevant coding standards. Develop and implement policies and procedures to improve coding accuracy and reimbursement rates. Collaborate with healthcare providers and administrative staff to address coding discrepancies and optimize healthcare reimbursement.

Skills:

The required skills such as Medical Billing, Medical Coding, and CPT Coding are essential for ensuring that all healthcare services are accurately documented and billed according to regulatory standards. Patient Collections and Medical Insurance Billing skills are used daily to manage accounts receivable and ensure timely payments from both patients and insurance companies. Knowledge of Private Pay and Medicare billing processes allows the manager to navigate complex reimbursement environments and resolve payment issues effectively. These skills are applied in training and supervising staff to maintain high coding accuracy and compliance. 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