Manager Professional Billing Coding Operations
Responsibilities
- Manage the day-to-day operations of the Professional Billing Coding Operations Team
- Supervise, mentor, and develop a group of certified professional coders
- Validate the accuracy of CPT, HCPCS, and diagnosis code assignments
- Perform quality assurance reviews of inpatient and outpatient records
- Review coding denials to identify trends and provide feedback to providers
- Partner with the Coding Education Team to design and implement training programs
- Ensure compliance with Official Coding Rules, Regulations, and payer guidelines
- Oversee coding edits and support external coding reviews such as RAC
Requirements
- Bachelor's degree or equivalent combination of education and experience
- CPC (Certified Professional Coder) certification required
- Minimum of five years of coding experience including education/mentoring/training
- Minimum of three years of management experience required
- Experience in acute care hospital coding with ICD-10-CM and CPT-4
- Strong knowledge of E&M coding, medical terminology, and anatomy
- Proficiency in computerized billing systems and Microsoft applications
Preferred Qualifications
- Experience in an academic medical setting or trauma center
- Prior experience working with claim edits and denials
About the Company
Boston Medical Center (BMC) is a leading provider of trauma and emergency services in New England. As a large safety-net hospital and primary teaching affiliate of Boston University School of Medicine, BMC is committed to providing exceptional, equitable, and accessible health services to the community.
