Director, PB Coding Operations – Education

🔥 12 hours ago

🇺🇸 United States – Remote

💵 $122k - $177k / year

⏰ Full Time

🔴 Lead

⚙️ Operations

👻 Ghost score 0%

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Boston Medical Center (BMC)

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1996

Boston Medical Center (BMC) is a 511-bed, equity-led academic medical center and a proud member of the Boston Medical Center Health System. BMC delivers a model of healthcare where innovative and equitable care empowers all patients to thrive. As a premier academic medical center in Boston, a national leader in clinical care, and the largest essential hospital in New England, BMC’s world-class clinicians provide comprehensive care in more than 70 specialties and subspecialties.

📋 Description

• Provide coding oversight and standards to ensure coding accuracy, compliance, and appropriate reimbursement across BUMG • Manage operational execution of coding standards in areas reporting to Revenue Cycle • Manage coding operations and oversee the effectiveness of the coding program • Oversee coding training across BUMG • Manage coding staff to ensure compliance with coding guidelines and regulatory agencies and appropriate reimbursement for services rendered • Facilitate accurate representation of professional coding and clinical documentation through ongoing education for physicians, coders, and practice staff • Direct coding activities to ensure accurate, consistent, and compliant coding for all services • Ensure quality reviews to validate coding accuracy • Participate in rejections, denials, and claims review with the billing team • Identify documentation and coding trends and collaborate with Leadership and Compliance on corrective action • Evaluate coding process success on an ongoing basis • Serve as the contact for professional coding across BUMG • Work with Human Resources and department managers to select qualified candidates • Manage personnel through training, directing, mentoring, and fostering quality and excellence • Monitor department productivity and performance to identify strengths and training opportunities • Advance professional growth through educational programs, workshops, and maintaining industry knowledge

🎯 Requirements

• Bachelor’s degree or equivalent combination of formal education and experience • CPC – Certified Professional Coder • Minimum of 10 years related experience in professional coding with ICD-9/ICD-10, E/M and CPT • Previous management experience required, including education, mentoring, and training • Expertise in ICD-9/ICD-10, CPT, and E&M coding principles and guidelines • Knowledge of MS, AP, and APR DRG systems, APG, and EAPGs • Knowledge of payer reimbursement methodologies, federal, state, and payer-specific regulations, policies, and compliance standards • Excellent written, verbal, and communication skills • Excellent critical thinking skills • Excellent skill in providing hands-on education to providers, including audit findings and improvement opportunities • Excellent organizational skills, including ability to multitask, prioritize essential tasks, follow through, and meet timelines • Ability to work cooperatively with members of the healthcare delivery team and staff • Ability to adapt to changes in workload and priorities and respond quickly to urgent requests • Ability to mentor, guide, and motivate direct reports through demonstration of best practices and leading by example • Must adhere to all of BMC’s RESPECT behavioral standards

🏖️ Benefits

• Medical, dental, vision, and pharmacy benefits • Discretionary annual bonuses • Merit increases • Flexible Spending Accounts • 403(b) savings matches • Paid time off • Career advancement opportunities • Resources to support employee and family well-being