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Medical Coding Manager - US Remote @ Independent

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 Medical Coding Manager - US Remote

Job Description

Role & responsibilities

1. Medical Coding Expertise

  • Deep knowledge of:
    • ICD-10-CM / ICD-10-PCS
    • CPT, HCPCS Level II
    • DRG (Diagnosis Related Groups)
    • HCC (Hierarchical Condition Categories) for risk adjustment
  • Experience with different specialties (inpatient, outpatient, ED, surgical, etc.)

2. Coding Software / Encoder Tools

  • Proficiency with tools like:
    • 3M Encoder
    • Optum EncoderPro
    • TruCode
    • QuadraMed

3. Clinical Documentation Improvement (CDI)

  • Understanding of how to bridge gaps between provider documentation and accurate coding
  • Collaborate with CDI specialists to ensure proper reimbursement and quality metrics

4. Audit & Quality Review

  • Conduct internal coding audits
  • Create audit workflows and reporting
  • Familiarity with OIG audit protocols, CMS guidelines

5. Compliance & Regulatory Knowledge

  • In-depth knowledge of:
    • HIPAA
    • Medicare/Medicaid rules
    • National Correct Coding Initiative (NCCI) edits
    • AHIMA/AAPC coding guidelines
  • Ability to update policies based on new regulatory changes

6. EHR & Practice Management Systems

  • Must know how to navigate:
    • Epic
    • Cerner
    • Athenahealth
    • Meditech
  • Understand integration between coding modules and billing workflows

7. Reporting & Metrics

  • Use Excel, Access, or BI tools to track:
    • Coding productivity
    • Error rates
    • Backlogs
    • Denial patterns due to coding issues

8. Project & Staff Management Tools

  • Familiarity with:
    • Workforce management systems
    • Task tracking tools (e.g., Jira, Trello, MS Project)
    • Productivity benchmarking tools (especially in remote environments)

Preferred candidate profile

1. Medical Coding Expertise

  • Deep knowledge of:
    • ICD-10-CM / ICD-10-PCS
    • CPT, HCPCS Level II
    • DRG (Diagnosis Related Groups)
    • HCC (Hierarchical Condition Categories) for risk adjustment
  • Experience with different specialties (inpatient, outpatient, ED, surgical, etc.)

2. Coding Software / Encoder Tools

  • Proficiency with tools like:
    • 3M Encoder
    • Optum EncoderPro
    • TruCode
    • QuadraMed

3. Clinical Documentation Improvement (CDI)

  • Understanding of how to bridge gaps between provider documentation and accurate coding
  • Collaborate with CDI specialists to ensure proper reimbursement and quality metrics

4. Audit & Quality Review

  • Conduct internal coding audits
  • Create audit workflows and reporting
  • Familiarity with OIG audit protocols, CMS guidelines

5. Compliance & Regulatory Knowledge

  • In-depth knowledge of:
    • HIPAA
    • Medicare/Medicaid rules
    • National Correct Coding Initiative (NCCI) edits
    • AHIMA/AAPC coding guidelines
  • Ability to update policies based on new regulatory changes

6. EHR & Practice Management Systems

  • Must know how to navigate:
    • Epic
    • Cerner
    • Athenahealth
    • Meditech
  • Understand integration between coding modules and billing workflows

7. Reporting & Metrics

  • Use Excel, Access, or BI tools to track:
    • Coding productivity
    • Error rates
    • Backlogs
    • Denial patterns due to coding issues

8. Project & Staff Management Tools

  • Familiarity with:
    • Workforce management systems
    • Task tracking tools (e.g., Jira, Trello, MS Project)
    • Productivity benchmarking tools (especially in remote environments)

Perks and benefits

Job Classification

Industry: Medical Services / Hospital
Functional Area / Department: Healthcare & Life Sciences,
Role Category: Health Informatics
Role: Medical Biller / Coder
Employement Type: Full time

Contact Details:

Company: Independent
Location(s): United States (U.S)

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Keyskills:   EHR & Practice Management Systems Clinical Documentation Improvement Coding Software / Encoder Tools Reporting & Metrics Medical Coding Expertise Audit & Quality Review

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₹ 22.5-30 Lacs P.A

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