General Manager Medical Coding

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Job Summary:

The GM of Medical Coding is responsible for overseeing the medical coding operations, ensuring compliance with industry regulations, maintaining high accuracy and productivity standards, and managing a team of coders. The GM will play a key role in driving efficiency, quality, and continuous improvement in the medical coding department, while collaborating with other departments to achieve organizational goals.

Key Responsibilities:

1. Team Leadership & Management

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• Lead and manage the medical coding team, ensuring high performance, engagement, and professional growth.
• Conduct regular training sessions to ensure staff is up to date with the latest coding practices and industry standards.
• Provide coaching and feedback to improve productivity and accuracy.

2. Operational Oversight

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• Oversee daily medical coding operations and ensure timely and accurate coding of healthcare services.
• Monitor workflow to ensure departmental goals are met, including productivity targets and quality assurance standards.
• Ensure compliance with the Health Insurance Portability and Accountability Act (HIPAA) and other regulatory requirements.

3. Quality Control & Compliance

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• Review coding work for accuracy, completeness, and adherence to current coding guidelines (ICD-10, CPT, HCPCS).
• Implement corrective actions and develop strategies to improve coding accuracy and minimize denials.
• Conduct audits and internal reviews to identify issues and implement solutions.

4. Collaboration & Reporting

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• Collaborate with clinical, billing, and other administrative teams to resolve coding-related queries.
• Analyze coding trends and provide reports to senior management for decision-making.
• Coordinate with insurance companies and healthcare providers to resolve coding discrepancies.

5. Process Improvement

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• Identify opportunities for process improvement within the coding department to enhance efficiency and reduce errors.
• Develop and implement best practices, standard operating procedures (SOPs), and training materials for the coding team.

6. Technology Integration

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• Stay up-to-date with coding software, electronic health record (EHR) systems, and new industry trends.
• Lead the integration of new tools and technologies to improve coding processes.

Key Requirements:

1. Education

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• Bachelor’s degree or a Master’s degree in any field.
• Certification in Medical Coding (e.g., CPC, CCS, CCS-P) is required.

2. Experience

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• At least 15 to 18 years of experience in medical coding, with a minimum of 8 to 10 years in a managerial role
• Experience in managing large coding teams and driving operational efficiency.
• Familiarity with ICD-10, CPT, HCPCS coding systems and compliance regulations.

3. Skills

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• Strong leadership, communication, and interpersonal skills.
• In-depth knowledge of medical coding practices, healthcare reimbursement, and regulatory requirements.
• Ability to manage and analyze large sets of data and make data-driven decisions.
• Proficient in using coding software, EHR systems, and MS Office Suite (Excel, Word, PowerPoint).

4. Personal Attributes

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• Attention to detail with a focus on accuracy and compliance.
• Ability to work under pressure and manage multiple priorities.
• Strong problem-solving and decision-making skills.