Coding Manager

🕒 5 dias atrás

🏖️ New Jersey – Remoto

🏖️ New Jersey – Remote

⏰ Tempo Integral

🟠 Sênior

🔴 Especialista

👔 Gerente

👻 Score fantasma 13%

O que significa: a chance de ninguém estar realmente contratando para esta vaga.Como ler: 60% ou mais significa que achamos que é uma vaga fantasma. Pontuações mais baixas preocupam menos.Por que essa pontuação:

• Aberta há 5 dias.
• Sem salário divulgado.

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HURC Healthcare Solutions

SiteLinkedInTodas as Vagas

501 - 1000 funcionários

Fundada em 2018

🏥 Saúde

⚕️ Seguro de Saúde

🎯 Recrutamento

Healthcare • Healthcare Insurance • Recruitment

A HURC Healthcare Solutions é uma empresa de serviços de saúde B2B que faz parceria com hospitais e organizações de provedores para gerenciar a revisão de utilização, as operações do ciclo de receita clínica e o alcance da saúde populacional. A empresa fornece Revisão de Utilização centralizada (CŪR), gestão do ciclo de receita que combina supervisão doméstica com recursos offshore, além de serviços de aumento de equipe e automação para maximizar a receita líquida de pacientes e reduzir os encargos operacionais. A HURC enfatiza serviços personalizáveis impulsionados por pessoas que se integram aos sistemas existentes dos clientes e preenchem a lacuna entre pagador e provedor para que os clínicos possam focar no atendimento ao paciente.

Descrição

• Supervise day-to-day coding operations for professional fee claims across multiple clinical specialties. • Monitor workflow and ensure compliance with standard operating procedures. • Provide hands-on support for complex coding reviews and escalated coding issues. • Monitor program performance and develop corrective action and improvement plans. • Identify opportunities to improve coding accuracy, reimbursement, productivity, quality, and financial performance. • Provide subject matter expertise in professional fee coding and billing. • Evaluate coding and billing workflows and identify operational gaps. • Review coding accuracy, productivity, quality, reimbursement, and compliance trends. • Evaluate documentation, coding, billing, reimbursement, and denials relationships. • Identify opportunities to reduce coding-related denials and prevent revenue leakage. • Evaluate charge capture, claim submission, edits, billing workflows, and payer requirements. • Partner with CDI, coding, utilization review, denials, and revenue cycle teams. • Serve as a client-facing leader for professional fee coding operations. • Lead coder and client meetings. • Develop recommendations based on client data, workflows, financial performance, and operational findings. • Establish relationships with coding leaders, providers, and stakeholders. • Manage client escalations and ensure timely resolution. • Identify opportunities to expand existing client relationships through additional solutions. • Support initiatives to improve clean claim rates, reduce denials, accelerate reimbursement, and improve net revenue. • Partner with clients to establish benchmarks and improvement targets. • Develop and interpret dashboards and performance reports. • Establish program baselines and measurable improvement targets. • Analyze productivity, quality, denial, reimbursement, and financial metrics. • Partner with analytics resources to develop client reporting. • Participate in implementation of new coding, billing, and revenue cycle programs. • Ensure coding and billing programs comply with federal and state regulations, payer requirements, and client policies. • Monitor coding quality and compliance. • Support internal and external audits. • Identify compliance risks and recommend corrective action. • Maintain appropriate documentation and audit trails. • Establish performance expectations and accountability. • Promote quality, accountability, continuous improvement, and client service.

🎯 Requisitos

• Bachelor’s degree in health information management, Healthcare Administration, Business, Finance, or related field; equivalent experience may be considered. • 7+ years of progressive experience in professional fee coding, billing, HIM, revenue cycle, or healthcare financial operations. • Must be credentialed coder with a minimum of one of these certifications: RHIA, RHIT, CPC, CCS, or CCS-P. • 2+ years of leadership or supervisory experience. • Strong understanding of professional fee billing and revenue cycle operations. • Experience working with healthcare clients, hospitals, health systems, or physician organizations. • Strong understanding of payer requirements and reimbursement methodologies. • Excellent written, verbal, presentation, and communication skills. • Experience with Epic or other major EHR platforms. • Experience with encoder, CAC, CDI, billing, or revenue cycle technology. • Experience with hospital denials and appeals. • Experience with revenue integrity. • Experience working with outsourced coding or revenue cycle organizations. • Experience managing multi-client or national healthcare programs. • Travel as needed.

🏖️ Benefícios

• Remote work arrangement • Full-time employment

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