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Manager, Professional Coding

Job ID 148080 Date posted 06/15/2018

Position Summary:
Under the Direction of the Director/Assoc Director of Professional Coding, the Professional Coding Manager will manage the Professional Coding staff for daily work flow, communication and education of coding guidelines. The Professional Coding Manager will monitor and report on coding work for quality, productivity, and compliance. The Professional Coding Manager will work to ensure proper coding following CMS and appropriate regulatory coding guidelines for quality and compliance. The Professional Coding Manager will develop goals to meet the overall goals of Lahey Health.

Essential Duties & Responsibilities including but not limited to:

1) Manages staff to established standards for quality and quantity of work performed. Responsible for developing departmental goals and objectives in accordance with overall department and facility goals and objectives.
2) Works with staff to ensure compliance of, and proper coding technique as defined by CMS regulations, Local Medicare Review Policies (LMRP?s), Local Carrier Determinations (LCD?s), the AMA, any applicable Lahey Health compliance policies, and/or any relevant accrediting organizations. Provides ongoing coding education as well as new coder education on proper coding and documentation.
3) Ensures that Coding staff reviews and updates any paper encounter forms/billing forms/and/or codes used for billing through interfaces on a regular basis.
4) Ensures that Coding staff conducts physician-coding audits and assists in communicating results and recommendations.
5) Ensures that Coding staff conducts new physician orientation and ongoing physician training as needed.
6) Works with Coding staff to analyze rejected claims and patient inquiries and recommends appropriate coding corrections.
7) Attends management meetings, interacts with other managers to resolve problems, and conducts regular staff meetings to ensure consistent communication of Coding department as well as Lahey policies, expectations, and goals. Acts as Liaison for Revenue Cycle Teams as appropriate.
8) Documents problems and handles complaints from employees, physicians and administration. Keeps Director informed of problems and challenges in the Coding Department.
9) Attends appropriate organizational and industry meetings to develop and maintain necessary Professional and Technical Coding knowledge as well as stays current will all billing regulations as they relate to coding. Follows all CMS, AMA, AHA, CPT, ICD-10, HCPCS, coding and billing guidelines.
10) Assist the Director with special projects as needed.
11) Maintains strict adherence to the Lahey Health Confidentiality policy.
12) Incorporates Lahey Health Guiding Principles , Mission Statement and Goals into daily activities.
13) Complies with all Lahey Health Policies.
14) Complies with behavioral expectations of the department and Lahey Health.
15) Maintains courteous and effective interactions with colleagues and patients.


Minimum Qualifications

Education: Coding Certificate and Bachelor Degree or Equivalent Experience Required (additional years of supervisory/management experience beyond the minimum qualifications)

Licensure, Certification & Registration: Coding Certificate from College Level Coding Program, and CPC, CCS-P, COC, or CCS required.

Experience: 5 years management in Healthcare Environment in a Professional Coding and/or Billing environment for a large Group Practice or equivalent experience.

Skills, Knowledge & Abilities: CPT, HCPCS, and ICD-10 coding for Professional Coding, Computer skills including Microsoft Word, Excel, Access, Powerpoint, and other basic computer skills. Excellent verbal and written communication skills required. Presentation Skills required.



About Lahey Health

The Lahey Model of Care - right care, right time, right place - is exactly what patients, providers and payers need and deserve. Identifying and delivering on this convergence of interests has positioned Lahey Health for further growth. Our model ensures care is highly coordinated and locally delivered, with lower costs and exceptional quality.

Lahey Health is a robust, regional system including a teaching hospital, community hospitals, primary care providers, specialists, behavioral and home health services, skilled nursing and rehabilitation facilities, and senior care resources throughout northeastern Massachusetts and southern New Hampshire. The system has a global presence with programs in Canada, Jordan and Bermuda.

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