Auditing inpatient medical records with a focus on coding accuracy and compliance. Responsible for mentoring coders with ongoing feedback and training.
About the role
- Lead Assistant Manager overseeing a team of medical coding specialists ensuring accurate auditing of surgical procedures. Stay current on coding regulations and collaborate with cross-functional teams.
Responsibilities
- Lead and manage a team of medical coding specialist ensuring accurate and timely auditing of procedures across various specialties in accordance with industry standards, guidelines and regulatory requirements
- Provide guidance, training, and mentorship to the coding team, fostering a collaborative and high-performing work environment
- Oversee the coding workflow, prioritize work assignments, and ensure productivity and quality targets are met or exceeded
- Stay updated with changes in coding guidelines, payer policies, and industry trends related to surgery coding and payment integrity process and effectively communicate these changes to the team
- Conduct regular audits and quality checks to ensure compliance with coding guidelines, accuracy of coded data, and adherence to documentation requirements
- Collaborate with other departments, such as analytics, repricing, quality, compliance to optimize coding processes and resolve coding-related issues
- Monitor key performance indicators (KPIs) and develop performance improvement initiatives to enhance auditing efficiency, accuracy, and productivity
- Apply payment integrity processes and knowledge to ensure proper coding and billing practices, identify claim and documentation errors and deficiencies, and maximize revenue capture
- Serve as a subject matter expert on multi-specialty surgery coding and payment integrity, providing guidance and support to physicians, clinical staff, and other stakeholders to ensure appropriate documentation, coding, and auditing practices
Requirements
- Bachelor’s degree in Clinical or Healthcare Information Management or a related field
- Relevant certifications (e.g. CPC,CIC,CCS for DRG) are mandatory
- Extensive experience in medical coding, with a focus on DRG coding and strong knowledge of CPT, ICD-10-CM, HCPCS coding systems
- Proficient in using coding software and electronic health record (EHR) systems
- Strong analytical and problem-solving skills, with the ability to identify coding-related issues, propose solutions, and implement process improvements
- Excellent interpersonal and communication skills, with the ability to collaborate effectively with diverse stakeholders and build positive relationships
- Detail-oriented with a commitment to accuracy and compliance with coding guidelines and regulations
- Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment
- Demonstrated knowledge of healthcare industry regulations such as HIPAA and HITECH, and specific knowledge of CMS, Medicare, LCDs, NCDs, Medical Policies, Commercial payer processes and requirements
Benefits
- EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process
- Corporate culture based on collaboration, innovation, excellence, integrity, and respect
- More than 54,000 employees spanning six continents
- Health care benefits along with paid time off
- Continuous education programs and training offered
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