The Regional Manager of Coding will be accountable for successfully managing the Medical Coding team, audit documentation and coding practices to ensure accuracy in the data provided to CMS across multiple Risk Bearing Entities (RBE’s). The Regional Manager will provide coding expertise as well as administrative oversight to ensure successful HCC initiatives. The Regional Manager will be responsible for managing contracted coding vendors to ensure accuracy and compliance with governing entities. Supervisory responsibilities include recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; and coaching, counseling, and disciplining employees.

• Ability to manage coding programs across multiple Risk Bearing Entities or multiple markets within an RBE.

• Manages multiple and large teams that have the potential to be geographically dispersed

• Monitor coding and abstracting productivity and quality to ensure coding quality and performance improvement standards are maintained, achieved, and improved.

• Partner with multiple markets and enterprise risk adjustment leadership to create and support adherence to performance guidelines in terms of quality and productivity measure

• Manage and maintain a comprehensive tracking and management tool for Coding workload and prioritization.

• Manage coding activities for all assigned coders and ensure that all tasks are completed in a timely manner.

• Ensure compliance with all applicable federal, state, and local regulations, as well as with institutional/organizational standards, practices, policies, and procedures.

• Assist with CMS Data Validation activities, including suggested record selections, tracking and submission, in conjunction with Risk Adjustment leadership teams.

• Keep updated on new statutes/regulations/policies and distribute updates as required

• Provide guidance in the coding/abstraction, production, and quality assurance, auditing, and training activities

• Support or perform chart reviews/HCC coding to ensure timely reviews

• Collaborate, develop, and sustain provider feedback and educational materials

• Provide regular reporting of key metrics

• Ability to work independently in a fast-paced environment

• Excellent verbal, written, and interpersonal communication skills

• Dependable, great attitude, highly motivated and a team player

• Possess strong organizational skills and attention to detail

• Other duties as assigned to meet the organization’s needs.

• 6+ years coding experience, including prior managerial experience

• 3+ years of Professional Coding experience in a medical group, IPA, MSO, or health plan setting is required

Education/Licensure:

• Bachelor’s Degree in business administration, Healthcare Management or in a related field or equivalent experience desired.

• One of the following Coding Certification CCS, CCS-P, CCA through AHIMA or CPC, COC, CIC through AAPC) required

• Additional CRC certification required

• Additional RHIA and /or RHIT preferred

• Proficient user in Microsoft Suite

1. Ability to be a team player and exercise initiative in responding to provider requests and concerns in a helpful and courteous manner

2. Provider contracting and customer service techniques

3. General understanding of the health care industry, ideally the provider relations field-desired

4. Excellent interpersonal and telephone communication skills are required

5. Exercise attention to detail; ability to provide accurate data entry

6. Ability to work under pressure with minimal supervision, multi-task, complete projects in a timely fashion and meet deadlines a must

7. Excellent analytical, problem solving and organizational skills a must.

8. Language Skills: Strong communication skills both written and verbal to work with multiple internal and external clients in a fast-paced environment

9. Mathematical Skills: Ability to work with mathematical concepts such as probability and statistical inference. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.

10. Reasoning Ability: Ability to apply principles of logical or scientific thinking to a wide range of intellectual and practical problems.

11. Computer Skills: Ability to create and maintain documents using Microsoft Office (Word, Excel, Outlook, PowerPoint)