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Requisition Number 18-0051
Post Date 2/14/2018
Title Senior Coding Manager
City Lafayette
State CO
Description This job exists to: The purpose of this position is to provide senior leadership to the coding staff, department operations, ensure complete and correct documentation and coding to produce clean claim output. Responsible for providing effective leadership and overseeing the duties and functions of the Coding staff and ensuring that they are carried out with accuracy, timeliness and confidentiality to ensure Clinica’s full compliance with federal and state requirements.


• Manage Coding staff in a centralized billing environment fully integrated with the Clinica team. Assure that the values that a centralized system brings (networking, collaboration between front/back end staff) are maintained in this process. Assure clinical, operational and financial department expectations for this role are met in the integration plan.
o Assure billers are fully trained on the NextGen EPM and EHR systems, to maximize their ability to correctly review, process and code encounters.
o Act as a mentor and coach for certified CPC staff, to educate them in coding/auditing and provider education.
o Work with Billing Manager to assure front end processes support reimbursement team needs.
• Lead organization and oversee the use of updated and most specific procedure and diagnosis codes are utilized.
• Provides program development and facilitation of communication between providers, coders, and other members of the revenue cycle team.
• Build, maintain, and manage department and staff by use of Key Performance Indicator (KPI) and Benchmarking.
• Oversee charge entry functions in NextGen EPM environment to include management of upfront claim edits and assuring correct procedure and diagnosis codes are correctly maintained and added in the EPM system.
• Develop and manage coding education program for clinical and billing staff with Senior Coding Auditor and Educator.
• Responsible for assuring Coding Compliance Plan is followed thoroughly. This plan includes regular audits and reporting of clinical documentation audits, billing and coding staff audits, and billing claim audits to assure accuracy and compliance of Plan. Works with Clinical Leadership to identify and correct coding inaccuracies that fall outside of Plan requirements.
• Required to be knowledgeable and compliant with all laws and regulations that apply to your area of responsibility. Required to act in full cooperation with Compliance Officer and to uphold our Compliance Plan.
• Work with Finance Leadership staff to identify revenue opportunities that exist and participate in solutions to improve revenue when possible.
• Participate with IPN and CCHN leadership to assure CFHS needs are maintained and to network and contribute to the global FQHC environment.
• Provides excellent customer service to Clinica patients and our internal customers, to include all employees of CFHS.
• Provides weekly and monthly reporting as required.
• Provides project management functions for coding related projects.
• Build a strong partnership with the Billing Manager.
• Support the Corporate Compliance Officer in assuring compliance with federal, state, and company rules, regulations, policies etc.; with regard to billing processes.


• Maintain a safe work environment:
o Implement, review, apply and actively enforce the clinic’s safety policies.
o Support the safety program by actively looking for opportunities to improve safety practices and evaluate staff for safety practices and ergonomic issues.
o Discipline staff when safety policies are violated.
• Compliance:
o Knowledgeable of and compliant with laws and regulations governing area of responsibility.
o Responsible for reporting any potentially non-compliant conduct.
o Cooperate fully with our Compliance Officer in upholding our Compliance Plan.
• Performs other duties and responsibilities as requested.


• Manage and coach staff.
• Setting performance goals and benchmarks for coding staff.
• Initial and annual Performance Evaluations.
• Disciplinary action as needed.
• Leadership and modeling of Clinica values.


• Authority for hiring and day to day coaching of staff.
• Final authority for decisions to terminate the employment of a staff member.

Progress is reviewed quarterly and results are measured and formally evaluated annually.


A. Education / Experience

• Current CPC certification from accredited National Organization. (AAPC or AHIMA).
• Minimum 5 years of previous supervisory management experience.
• 3-5 years experience in Healthcare Management with knowledge of various payment programs and insurers.
• Proficiency in Medicare Part B, Medicaid programs, Managed Care models and third-party payer guidelines.
• Bachelor’s degree in Healthcare related field, Business Administration or applicable other degree preferred.
• ICD-10 certification preferred.

B. Knowledge, skills and abilities:

• Community Health Center office experience a plus
• Expertise in CPT, HCPCS, CDT, and ICD
• Advanced Microsoft Excel skills
• Knowledge of NextGen EHR and EPM
• Office skills including typing, accounting, 10 key entry, filing, computer usage required
• Good team building skills required.
• Good organization skills required.
• Ability to manage multiple projects
• Ability to delegate responsibility and authority to staff required.
• Good oral and written communications skills required.
• Ability to establish and monitor performance/production standards
• Bilingual: Spanish and English preferred.

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An Equal Opportunity Employer