Hospital Manager of Clinical Coding
The Hospital Manager of Clinical Coding is a management position providing subject matter expertise to support the LifeCode engine, computerized coding software that utilizes state-of-the-art Natural Language Processing (NLP), to ensure high quality ICD-9-CM and CPT code assignment. This position requires strong organizational and leadership skills with a customer service focus. This individual leads a coding team that specializes in hospital coding, a team of certified medical coding professionals. The coding team is part of the product development team and works closely with NLP and software engineering staff. The manager ensures that product releases are compliant with coding guidelines, coordinates efficient delivery of customer coding support, and provides coding expertise to the sales team.
Essential Duties and Responsibilities:
- Coordinates with product management and the NLP manager the process for defining requirements for ICD-9-CM, ICD-10-CM, ICD-10-PCS, CPT and HCPCS code development to support periodic releases of the LifeCode engine.
- Defines metrics that track productivity and quality of customer coding support and implementation and enforces performance standards. Reports metrics to senior management on a regular basis.
- Designs internal coding training programs, ensuring that all coding team members maintain certification and sustain a high level of coding expertise.
- Mentor new coding team members across multiple coding specialties and ensure that all coding specialties have primary and back-up resources available.
- Coordinates with sales management to provide skilled coding resources for product demonstration, QA with potential customers, and sales test analysis.
- Interacts with Development, QA, Project Management, Customer Support and Sales to identify development priorities and resolve customer coding issues.
- Collaborates with product management and the development team on the impact of longer terms trends related to new coding guidelines, quality reporting, pay-for-performance and new technology.
- Suggests product enhancement ideas based on subject matter expertise in coding and billing.
- Provides guidance to the development and product management on the industry transition to ICD-10 and requirements for both internal and customer training, product validation and payer reporting.
- Provides detailed coding feedback on regression and functional tests using Windows based quality assurance software.
- Specifies requirements for document filtering to optimize performance of the LifeCode engine for ICD, CPT and HCPCS coding.
- Analyzes coded data and clinician documentation to provide relevant examples for the NLP development team and provide feedback for customer service and sales.
- Applies coding principles and guidelines in the assignment of diagnosis and procedure codes.
- Applies knowledge of medical terminology, anatomy, physiology and pathophysiology in the assignment of appropriate codes.
OptumInsight is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
OptumInsight is one of the largest and fastest growing health information companies. We specialize in improving the performance of the health system by providing analytics, technology and consulting services that enable better decisions and results. We integrate workflow solutions that deliver data in real-time, and create actionable insights - processing health information that relates directly to and affects one in four patients in the U.S, one in every three Medicaid dollars and one in every five emergency room visits. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation Performance.
What can YOU do with the right information? At OptumInsight, the possibilities and the impact are limitless. No matter what your role is at OptumInsight, you'll be empowered to ask more questions, develop better solutions and help make the health care system greater than ever. It's always fresh. It's always exciting. And it's never been more important.
- Requires Community College degree or certificate; Bachelors degree is a plus
- Must have at least one of the following: CPC, CPC-H, CCS, CCS-P, RHIT
- Minimum 10-15 years medical coding and billing experience required
- At least 4 years of management or supervisory experience is required
- Strong working knowledge of inpatient and outpatient hospital coding and billing
- Experience in coding of multiple outpatient specialties is required, such as radiology, emergency medicine, and same-day surgery
- Strong techinical knowledge of healthcare domain
- Strong computer proficiency with MS Word and Excel
- Demonstrated ability to lead a team and to handle a variety of tasks is crucial
- Ability to motivate, train and recruit a high-quality coding professionals
- Working knowledge of healthcare, hospital, billing companies, medical record coding and auditing
- Strong written and oral communication skills
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.