Manager - Operation

• Strong expertise in multi-specialty surgical coding, auditing, and payment integrity processes. 


• In-depth knowledge of ICD-10-CM, CPT, HCPCS, modifier usage, and payer-specific coding guidelines. 


• Comprehensive understanding of CMS, Medicare, Medicaid, LCDs, NCDs, commercial payer policies, and reimbursement methodologies. 


• Proficiency in coding software, auditing tools, and Electronic Health Record (EHR) systems. 


• Strong analytical and problem-solving abilities with a focus on identifying coding discrepancies and implementing process improvements. 


• Excellent leadership, coaching, and team management skills. 


• Effective communication and stakeholder management skills with the ability to collaborate across departments. 


• High attention to detail and commitment to coding accuracy, compliance, and quality standards. 


• Ability to manage multiple priorities, work independently, and meet deadlines in a fast-paced environment. 


• Sound knowledge of healthcare regulations, including HIPAA, HITECH, and industry compliance requirements. 

• Lead and manage a team of medical coding specialists, ensuring accurate and timely auditing of multi-specialty surgical claims. 


• Provide coaching, training, and mentorship to enhance team performance and foster a collaborative work environment. 


• Oversee coding workflows, assign priorities, and ensure productivity, quality, and turnaround time targets are consistently achieved. 


• Stay current with coding guideline updates, payer policies, regulatory changes, and industry best practices, and communicate relevant updates to the team. 


• Conduct regular coding audits and quality reviews to ensure compliance with coding standards, documentation requirements, and organizational policies. 


• Collaborate with cross-functional teams, including Analytics, Repricing, Quality, and Compliance, to optimize coding operations and resolve coding-related issues. 


• Monitor and analyze key performance indicators (KPIs), identify performance gaps, and implement continuous improvement initiatives. 


• Apply payment integrity principles to identify coding inaccuracies, documentation deficiencies, billing errors, and revenue optimization opportunities. 
  
  
  
  • Serve as the subject matter expert (SME) for multi-specialty surgical coding and payment integrity, providing guidance to internal stakeholders and supporting accurate documentation and coding practices. 
  
  


• Ensure compliance with healthcare regulations, including HIPAA, HITECH, CMS, Medicare, and commercial payer requirements.

Experience:

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  CPC+ 3 years' experience in multi-specialty surgery coding including IVR, General surgery, Infusion and Injection and Radiation oncology 



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  Auditing and denial management experience (Optional) 



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  Extensive experience in medical coding, with a focus on surgery coding and strong knowledge of CPT, ICD-10-CM, and HCPCS coding systems.

  
  

  Qualification:



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  Bachelor’s degree in clinical or healthcare information management or a related field. Relevant certifications (e.g. CCS, CPC, CPMA) are mandatory.

  
  

  Communication Skill: 



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  Strong written (documentation) and oral communication skills

  
  

  Working Hours:



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  40 hours per week as Full-time employee



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  Shift time: 8:00 PM IST - 5:00 PM IST



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  Weekends Off

  
  

  Telecommuter/Internet requirements, if applicable:



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  High Speed internet connection at home, must be broadband



• Must understand and adhere with telecommuter policy.