Manager -Operation
Manager - operations is responsible for leading and managing a team of medical coding specialists to ensure accurate and compliant auditing of surgical procedures across multiple specialties. This role oversees coding workflows, ensuring productivity, quality, and turnaround time targets are consistently achieved. The manager will provide training, mentorship, and ongoing guidance to enhance team performance and coding accuracy. They will stay updated on coding guidelines, payer policies, and regulatory requirements, ensuring effective communication and implementation within the team. Additionally, the role involves collaborating with cross-functional teams to optimize processes, improve payment integrity, and drive continuous improvement initiatives.
- achelor's degree in Healthcare, Life Sciences, or Health Information Management (or related field).
- Mandatory certifications such as CCS, CPC, or CPMA.
- Extensive experience in medical coding with strong expertise in surgery coding.
- In-depth knowledge of CPT, ICD-10-CM, and HCPCS coding systems.
- Strong understanding of payment integrity processes and auditing methodologies.
- Experience working with EHR systems and coding software.
- Knowledge of healthcare regulations including HIPAA, HITECH, CMS, Medicare, LCDs, NCDs, and commercial payer guidelines.
- Excellent analytical and problem-solving skills with attention to detail.
- Strong communication and stakeholder management skills.
- Ability to manage teams, prioritize tasks, and perform in a fast-paced environment
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- Lead and manage the surgery coding team to ensure accurate, compliant, and timely auditing of medical records.
- will have to work on New Implementation/Recruitment/CTA/OPS Efficiency/Quality MIS
- Oversee daily workflow, allocate tasks, and monitor productivity and quality metrics.
- Conduct regular audits and quality checks to ensure adherence to CPT, ICD-10-CM, and HCPCS coding standards.
- Provide training, mentorship, and performance feedback to team members.
- Stay updated on coding changes, payer policies, and regulatory guidelines, and cascade updates to the team.
- Collaborate with analytics, compliance, and operations teams to resolve coding issues and improve processes.
- Monitor KPIs and implement performance improvement strategies to enhance efficiency and accuracy.
- Apply payment integrity principles to identify coding discrepancies, documentation gaps, and revenue leakage opportunities.