Description
Designation: Manager - Medical Coding
Work Mode : Work from Office
Shift Timings : 6.30 pm to 3.30 am IST
Location : Ganapathy, Coimbatore
Position Overview: We are seeking a skilled and experienced individual to join our team as a Medical Coding Manager. The ideal candidate will possess a deep understanding of medical coding principles, regulations, and industry standards. They will be responsible for overseeing the coding operations, ensuring accuracy, compliance, and efficiency in all coding processes.
Role Prerequisites:
Minimum of 6 years of experience in the Medical coding domain is a must
Currently working for a min of 3 years at least as SME, Team Lead, Team Coach or Team Manager is a must
Should have experience of Team Management of upto 10 members.
BPT, MPT, BSC Nursing, MSC Nursing, B Pharm, M Pharm, BOT, Life Science is preferred.
AHIMA/AAPC/CCA/CPC/CCS certification is a must
MBBS, BDS, BAMS, BHMS, BUMS etc would be an added advantage
Should be conversant with core coding guidelines and best practices with strong knowledge of NCCI edits, local and national policies (CMS guidelines)
In-depth knowledge of medical coding principles, including ICD-10, CPT, HCPCS, and DRG systems.
Familiarity with electronic health record (EHR) systems and coding software applications
Familiarity with coding software systems, such as 3M Encoder, Optum360 Encoder, or TruCode
Attention to detail and accuracy in assigning codes and reviewing medical documentation
Good Knowledge of Microsoft Excel and PPT
Key Responsibilities:
Process:
Responsible for the day to day planning as well as work allocation for the entire team
Ensuring regular as well as on time floor and knowledge support for all the team members
Develop / maintain monthly coding production and accuracy reports to track and optimize internal productivity & quality improvement activities
Creating and Implementing SOPs
Ensure all coder/specialist performance data is maintained and shared as and when required
Accountable for client delivery SLAs including meeting turnaround time (TAT), daily/weekly/monthly volume deliverables and Quality
Partner with the recruitment team in the hiring efforts of OPX Global.
Stay up-to-date on changes in healthcare regulations, coding guidelines, and reimbursement policies to ensure compliance and accuracy.
People:
Accountable for overall performance of the team as well as people metrics such as attrition (retention), absenteeism, schedule adherence, TOS
Ensuring upskilling of team members through constant coaching and feedback, execution of individual development plans and completion of performance appraisals on time
Ensuring high engagement levels in the team through various ESAT initiatives such as huddles, team meetings and EMPOWER connects
Train the team on the latest updates in regards to coding and documentation. Work with training and quality team members to make sure there is ongoing training for the team based on feedback from quality
Train the coders on various client specifications
Responsible for understanding people's concerns and coordinating with required stakeholders for solution and escalate/highlight for any support required from PL
Define career paths and development goals for every individual in the team
Ensuring a Learning culture through constant training needs identification, training program coverage at all levels as per development plans for his/her account/department designed in the Career Architecture
Ensuring that all programs planned for Self Development are completed
Client:
Identify areas for provider education and prepare notes
Responsible for all client reports including report cards, production report and quality report
Responsible for all client workflows, reconciliation and closure
Responsible for bringing any clarifications to client and get it resolved and guide the team based on the response
Lead scheduled client calls on agenda as well document MOM
Assist PL on MBR, QBRs for performance presentations and agenda items, follow up action items and closure
Responsible for addressing all client concerns, issues at 1st level along with closing the loop to client
Responsible for responding to all client emails in a timely manner (ideally within 24 hrs)
Custodian of process SOP and own the update management and sign off from client
Accountable for delivering service as per client SLA including meeting TAT, volumes and quality
Financial:
Responsible for driving the topliner of P&L - Volumes for transactional model and resources and productivity on FTE model
Take initiatives on any revenue uplift by processing additional volumes without increasing resources/cost
Primarily assist on driving all efficiency measures at team level along with PL for cost efficiency
Assist PL on keeping the right mix of resources from cost perspective