Manager, Coding and Revenue Integrity

🕒 Setembro 10

🦌 Connecticut, New York, +2 estados a mais – Remoto

🦌 Connecticut – Remote 🗽 New York – Remote 🍂 Massachusetts – Remote ⚓ Rhode Island – Remote

💵 $93.500 - $140.300 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

👻 Score fantasma 9%

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 63 dias.
• As vagas desta empresa costumam ser preenchidas em 36 dias.

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Spire Orthopedic Partners

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 2021

🏥 Saúde

🤝 B2B

🏢 Corporativo

Healthcare • B2B • Enterprise

A Spire Orthopedic Partners é uma parceira de capital e gestão voltada para o futuro para cirurgiões ortopédicos e de coluna líderes, operando como uma organização de serviços de gestão (MSO) que fornece infraestrutura administrativa e suporte estratégico. A empresa faz parceria com práticas ortopédicas de alto crescimento em todo o Nordeste dos Estados Unidos (Connecticut, Nova York, Massachusetts, Rhode Island), permitindo que cerca de 165 médicos e 1. 800 funcionários em 40 locais cresçam, se especializem e foquem no cuidado ao paciente, enquanto a Spire lida com operações, integração de práticas e desenvolvimento de negócios.

Descrição

• Oversee processes ensuring accurate coding compliance, billing integrity, reimbursement, and revenue cycle performance • Onboard new and additional coders, including participating in interviews, training on systems, and monitoring proficiency and accuracy for 30 days • Monitor charge capture processes for accurate and timely billing • Analyze billing edits, denials, underpayments, and reimbursement trends • Ensure compliance with federal, state, and payer billing regulations • Develop and maintain standardized professional billing workflows, coding policies, and training • Monitor coding volume and coder workload to ensure adequate distribution and timely chart coding • Establish backup plans and cross-coverage for absences • Partner with Coding, Billing, Compliance, IT, and Clinical Operations • Provide annual coding updates for staff, providers, and leadership in collaboration with the Director of Billing and Coding • Coordinate audits and corrective actions related to billing practices • Conduct internal audits of documentation, coding, and billing accuracy • Monitor compliance with CMS, payer, and regulatory guidelines • Prepare reports and recommendations for leadership • Support external audits and payer reviews • Track revenue cycle metrics and KPIs • Present findings and strategic recommendations to senior leadership • Perform other duties as assigned

🎯 Requisitos

• Bachelor's degree preferred; equivalent experience may be considered • Active coding certification required (CPC, CCS, CCS-P, COC, or equivalent) • Minimum 5 years of progressive experience in professional billing, revenue integrity, coding, or revenue cycle operations • Minimum 3 years of leadership or supervisory experience • Advanced knowledge of professional billing workflows, charge capture processes, payer reimbursement methodologies, and denial management • Strong understanding of CPT, HCPCS, ICD-10-CM, and modifier application • Ability to analyze complex data sets and implement operational improvements • Strong written and verbal communication skills with ability to engage physicians, operational leaders, and executives

🏖️ Benefícios

• Excellent growth and advancement opportunities • Dynamic environment • Access to a diverse network of practitioners • Broad infrastructure of tools and programs to enhance the employee experience • Competitive Compensation • Generous PTO • Health, dental, and vision benefits • 401(k)

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