Operations Manager-Medical Coding

1. Leadership and Team Management:

• Provide leadership, guidance, and mentorship to a team of medical coding professionals.
  
• Foster a culture of excellence, collaboration, and continuous learning within the coding team.
  
• Set clear goals and performance expectations for team members and provide ongoing feedback and coaching to support their professional growth and development.
  

2. Coding Operations Oversight:

• Oversee all aspects of medical coding operations, ensuring adherence to industry standards, regulatory requirements, and organizational policies.
  
• Monitor coding productivity and accuracy metrics, identifying opportunities for improvement and implementing strategies to enhance performance. o Conduct regular audits and reviews to assess coding quality and compliance, implementing corrective actions as needed.
  

3. Process Optimization and Innovation:

• Collaborate with cross-functional teams to streamline coding processes, improve efficiency, and drive automation initiatives.
  
• Stay abreast of industry trends, emerging technologies, and regulatory changes impacting medical coding practices, and proactively incorporate best practices and innovations into coding operations.
  

4. Compliance and Regulatory Compliance:

• Ensure coding practices align with relevant regulatory requirements, including ICD-10-CM, CPT, and HCPCS coding guidelines.
  
• Develop and implement policies and procedures to promote coding compliance and mitigate compliance risks.
  
• Serve as a subject matter expert on coding-related compliance matters, providing guidance and support to internal stakeholders.
  

5. Stakeholder Collaboration:

• Collaborate closely with other departments, including revenue cycle management, clinical documentation improvement, and compliance, to optimize coding processes and promote cross-functional alignment.
  
• Partner with healthcare providers, payers, and external vendors to address coding-related issues, facilitate communication, and drive resolution of coding-related challenges.
  

Qualifications:

• Bachelor's degree in Health Information Management, Healthcare Administration, or related field required; Master's degree preferred.
  
• Certified Coding Specialist (CCS) certification required; additional coding certifications (e.g., CPC, CRC, CCS-P) preferred.
  
• A minimum of 10 years of leadership experience within a healthcare environment, including at least 7 years of medical coding experience with progressively increasing leadership responsibilities. 
  
• In-depth knowledge of ICD-10-CM, CPT, HCPCS coding systems, and coding guidelines.
  
• Strong understanding of healthcare reimbursement methodologies, compliance requirements, and regulatory guidelines.
  
• Excellent leadership, communication, and interpersonal skills, with the ability to effectively collaborate with diverse stakeholders.
  
• Proven track record of driving process improvement initiatives and achieving measurable results.
  
• Proficiency in healthcare information systems and coding software (e.g., EPIC, Cerner, 3M Codefinder) preferred.