Mgr Medical Coding

Position Title:

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Job Description:

Responsible to manage a team of clinicians and/or medical coders charged with promoting quality member outcomes, to optimize member benefits, and to promote effective use of resources.
Primary duties may include, but are not limited to: Ensures adherence to medical policy and member benefits in providing service that is medically appropriate, high quality, and cost effective. Oversees Complex Clinical Audit operations to ensure accuracy, efficiency, and compliance with coding standards and payer requirements, while driving performance, resource planning, and process improvements, serves as the key liaison across clinical, coding, and compliance teams, monitors audit trends and risks, ensures audit readiness, leverages data analytics for decision-making, and champions automation to streamline workflows and enhance operational outcomes. Hires,...