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Manager - HIS Professional Coding Integrity
Manager - HIS Professional Coding Integrity-March 2024
Findlay
Mar 28, 2026
About Manager - HIS Professional Coding Integrity

  PURPOSE OF THIS POSITIONThe primary purpose of this position is to manage the overall operations of the professional coding integrity team, including the overall performance of the professional coding program to ensure consistency, accuracy, compliance, optimal reimbursement and reduced denials. The Manger will collaborate with providers and clinical department leadership to support the integrity of the documentation to support the charges entered and the codes assigned. This position reports to the Director of Health Information Services. The Professional Coding Integrity Supervisor, the Professional Coding Auditor and Educator and the Professional Coding Claims Resolution Specialist positions report directly to this position.JOB DUTIES/RESPONSIBILITIESDuty 1: Provide management oversight of the professional coding integrity team and related functions with the primary objective to support the optimal performance of the profee coding program, which includes proper ICD-10 / CPT code assignment to ensure compliance with applicable regulatory standards, maintain high level of quality and consistency, optimize reimbursement, and reduce denials. Effectively communicate and solicit input from team and other impacted areas to promote a collaborative and innovative team environment, translates BVHS's Mission, Vision and Values into front-line action.Duty 2: Perform and/or provide oversight to managerial administrative support functions including but not limited to facilitate the recruiting and hiring process, training & education of associates, monitor appropriate staffing levels, payroll, performance evaluations, recognition and reward, disciplinary follow up as appropriate, establish/monitor performance metrics, monitor completion of organization requirements. Assists Director in developing and monitoring department budget and strives to control departmental costs.Duty 3: Active engagement to support organization cascading goals initiative, including idea boards, associate engagement, service excellence and contribution margin.Duty 4: Recommends and implements professional coding compliance plan and related policies and procedures to promote compliant and consistent coding practices, inclusive of ICD/CPT code assignments which are reflective and supported by clinical documentation. Monitors and modifies plan in anticipation of changing organizational needs (e.g. implement a new service line) and/or in response to revised regulatory requirements (e.g. IPPS and OPPS annual updates, CPT Assistant, Coding Clinic, etc.). Ensure appropriate dissemination of information and education to ensure coding integrity team and/or any other pertinent individuals or departments remain current on coding compliance plan/policies and procedures.Duty 5: Provides oversight of the professional coding integrity quality audit program to ensure the overall accuracy of work performed. Oversees and monitors the results of quality audits performed by Professional Coding Auditor and Educator and supports the resolution of identified opportunities through the creation and implementation of an action plan. Monitors third party payer audits and assists, as necessary, defending takebacks and in the appeal process related to code assignments and evaluate opportunities to reduce coding denials. Ensures relevant decisions related to coding practice are documented in policies or procedures to promote ongoing standardization and consistency.Duty 6: Develop and track key metrics to measure overall performance of team operations. Analyze data to determine opportunities for improvement and implement follow up or action plans to address. Evaluate workflows and processes to address issues that may be causing delays or for opportunities to continue to optimizApply here: https://www.aplitrak.com/?adid=YmJnZW5lcmljLjQ0NTk1LjEwNTA4QGJsYW5jaGFyZHZhbGxleWNvbXAuYXBsaXRyYWsuY29t

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