Senior Manager Quality Medical Coding

You have excellent domain expertise and process knowledge about Revenue Cycle Management (RCM) for Hospital facilities and Physicians. You possess a deep understanding of the differences between Facility hospital and Physician coding, particularly in the specialties of E&M-IP/OP. Your knowledge includes EM IP/OP, APC for optimizing reimbursement, UHDDS and guidelines, Level of service determination emphasizing Physical Examination & Medical Decision Making in Documentation guidelines, and hospital E&M coding for initial/subsequent visits. Additionally, you have a good understanding of Human Anatomy, Physiology, Pathophysiology, Pharmacology, Diagnostic Studies, Conservative and Surgical Treatments. You are familiar with Operative Reports and other report types along with their documentation requirements. Furthermore, you are aware of the consequences of risky practices such as up-coding and down-coding, Fraud and abuse, inflated documentation, HIPAA, and CLIA rules mandating claim transmission. As part of your responsibilities, you will supervise and manage a team of over 100 Quality Analysts. Your role includes creating an inspiring team environment with open communication, designing QA capacity planning based on project requirements, delegating tasks, and setting deadlines. You will be managing the quality of Outpatient (ED/EM/SDS/ANC/OBV), ProFee Surgery & EM, and Inpatient DRG projects in alignment with client Service Level Agreements (SLA). It is essential to ensure the effective implementation of the organization's Quality Management System, monitor team performance and metrics, and conduct random audits and Root Cause Analysis (RCA) on audit observations. You will identify knowledge gaps, develop action plans with quality leads and operation managers, discover training needs, and provide coaching to Quality Analysts. Listening to team members" feedback, resolving conflicts, recognizing high performance, rewarding accomplishments, encouraging creativity and business improvement ideas, suggesting and organizing team building activities, and identifying improvement opportunities while initiating action plans for improvement are key aspects of your role.,