Job Title: Manager, Provider Coding Education & TrainingClassification: ExemptDepartment: ManagementReports To: AVP, Revenue CycleHours: Vary depending on business needsSUMMARY: The Manager, Provider Coding Education and Training for Orthopedic Surgery is responsible for overseeing the development, delivery, and continuous improvement of coding education programs for healthcare providers within an orthopedic surgery specialty. This role ensures compliance with regulatory standards, optimizes reimbursement processes, and enhances the accuracy of coding practices. The manager will work closely with orthopedic surgeons, coding professionals, and billing departments to ensure accurate and efficient documentation and coding practices. This position plays a critical role in ensuring accurate coding for orthopedic surgeries, maximizing reimbursement, and maintaining compliance with industry standards.ESSENTIAL DUTIES:Education and Training Development:
- Design and implement specialized coding education programs tailored to orthopedic surgery.
- Develop training materials, coding manuals, and reference guides specific to CPT, ICD-10, and HCPCS codes used in orthopedic surgery.
- Conduct regular coding workshops, webinars, and in-person training sessions for providers and clinical staff.
- Ensure educational content is up-to-date with the latest coding regulations, payer guidelines, and coding best practices.
Compliance and Quality Assurance:
- Monitor coding practices to ensure compliance with federal, state, and organizational guidelines.
- Perform audits and reviews of orthopedic surgery coding to ensure accuracy and proper documentation.
- Collaborate with compliance teams to mitigate coding risks and address audit findings.
Provider Support:
- Serve as a subject matter expert on orthopedic surgery coding and provide ongoing support to providers and clinical staff.
- Act as a liaison between coding professionals and providers to resolve coding queries and discrepancies.
- Assist in resolving complex coding issues and ensure proper coding for unique and challenging cases.
Process Improvement and Optimization:
- Evaluate and refine existing coding processes and education strategies to improve accuracy and efficiency.
- Analyze coding-related performance metrics (e.g., claim denials, reimbursement trends) and implement corrective actions.
- Keep abreast of orthopedic surgery advancements and ensure coding education aligns with new techniques, procedures, and technologies.
Leadership and Team Management:
- Provide leadership, mentorship, and performance feedback.
- Coordinate with cross-functional teams including billing, compliance, and clinical operations to ensure cohesive and effective coding practices.
- Manage department budgets, resources, and schedules to meet organizational goals.
Reporting and Documentation:
- Prepare regular reports on coding accuracy, training outcomes, and compliance metrics.
- Track and document education sessions, coding audits, and corrective action plans.
Physical Demands:The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
- While performing the duties of this job, the employee is regularly required to talk and hear.
- This position can be very sedentary; requiring long periods of sitting, active listening and computer work. The employee may rarely lift or move objects weighing over 50 pounds.
- Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
Travel:
- This position may require travel to various business locations for training sessions or provider meetings.
Required Education and Experience:
- Bachelor's degree in healthcare administration, health information management, or a related field (Master's preferred).
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Orthopedic Surgery Coder (COSC) preferred.
- Minimum of 5 years of coding experience, with a focus on orthopedic surgery.
- Prior experience in a management or leadership role in a healthcare setting.
- Strong understanding of orthopedic surgery procedures, medical terminology, and coding guidelines (CPT, ICD-10, HCPCS).
- Excellent communication, leadership, and organizational skills.
Preferred Skills:
- Experience with coding audits, revenue cycle management, and compliance.
- Familiarity with EHR systems and coding software; eCW experience a plus.
- Ability to work collaboratively with providers, clinical staff, and coding teams.
- Strong problem-solving skills and attention to detail.
Work Authorization: Must be able to provide required documentation stating that the employee is legal to work in the United States.EEO: Orthopedic Associates of SW Ohio, Inc. is an equal opportunity employer and does not discriminate against applicants or employees on the basis of sex, race, color, religion, national origin, ancestry or age (40 years of age and over), qualified individuals with disabilities, or any other factors protected by federal, state or local law.Other Duties: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.