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Billing and Coding Manager Job in Boston, Massachusetts

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Job Title: Billing and Coding Manager

Employer:Centering Healthcare Institute
Job Location:Remote
Preferred Certifications:RHIA,COC,CCS,RHIT,CPC
Required Experience:3 to 4 years
Preferred Experience:3 to 4 years
Location:89 South Street, Suite LL02 Boston 02111, MA, US
* Note: This listing is for a remote position
Date Posted:9/29/2021
??Join an organization at the forefront of improving health by transforming care through Centering® groups

Billing and Coding Manager

The Centering Healthcare Institute (CHI) actively seeks to build a diverse staff that is reflective of the populations we aim to serve and the communities where we work. CHI encourages multiple perspectives and experiences and strives to hire and retain a diverse workforce. Our employees are passionate, curious, and eager for the challenge of changing healthcare.

About Centering Healthcare Institute

CHI is on the front lines of transforming healthcare delivery and increasing the opportunities that people have to thrive. With over two decades of experience working closely with healthcare providers from all sectors, we’ve developed the Centering group care model. Our team provides implementation support to guide healthcare practices through every step of the system redesign and to build a foundation for a successful, sustainable practice. We have developed curricula and patient materials, and our facilitation training offers a variety of skill-building and interactive learning activities that prepare facilitators to lead engaging groups. We offer practice management and support tools, and site accreditation for model fidelity and quality assurance. We are engaged in advocacy efforts for payment reform and community outreach to achieve the Quadruple Aim of better health, better care, lower cost and provider satisfaction. Leadership and collaboration are at the heart of our success.

The Position

The Billing and Coding Manager reflects the mission, vision, and values of Centering Healthcare Institute and adheres to the organization's standard policies, procedures. This is a new position for Centering Healthcare Institute, and the successful candidate will have a critical role in developing this position and over time building out a team of billing/coding experts for our clients.

The Billing and Coding Manager will work directly with CHI’s Centering practice sites clinical and financial departments and acts as a key collaborator to ensure the medical record accurately reflects the patient's service associated with the Centering group care model. This position provides healthcare-related financial and coding expertise and training to clinical, operational and finance team members regarding Centering sites’ documentation, billing, and coding. The Billing and Coding Manager also demonstrates expertise to resolve billing claim denials. This position will have a critical impact on our sites’ ability to improve Centering’s business performance in term of operations, profitability, management, structure, and strategy. The successful candidate will bring creativity to the position and a unique ability to align services provided through Centering care with proper billing/coding procedures.

The Billing and Coding Manager is responsible initially for focusing on key states where Centering has enhanced reimbursement policies and building out a framework for the technical support the position can provide to our client practices. In addition, as the processes and focus of the role are better understood, the successful candidate will be responsible for making organizational recommendations on the staffing model needed to provide robust billing/coding support to our clients.

Position Details
• Works collaboratively with the practice sites to analyze data to identify and understand issues to be addressed
• Trains Centering practice sites providers, financial staff, and other operational team members regarding documentation, billing and coding rules and regulations for both in-person and telehealth Centering models
• Provides assistance to multiple provider types (e.g., FQHCs, academic practices, midwifery practices) who contract with multiple payers (e.g., commercial, Medicaid, etc.)
• Identifies charge capture opportunities consistent with the Centering group care delivery within the practice site
• Provides documentation feedback to physicians, mid-level providers, and other Centering practice site team members
• Maintains coding reference information
• Reviews and communicates new and/or revised billing and coding guidelines and related information
• Provides advice, guidance, with implementation plans, and/or suggestions for improvement for operational workflow within the state Medicaid and other payer guidelines
• Develops and designs FAQs related to coding/billing guidelines to include screenshots, short video guidance, and webinars on CHI’s site portal
• Supports all teams in the organization including sales, implementation advisors, practice service representatives and technical assistance staff
• Maintains subject-matter expertise and capability on all clinical and diagnostic service lines related to revenue operations, claims generation and compliance
• Develop site-facing guidance and resources for recommending charges and/or charge practice corrective measures and monitoring tools to safeguard revenue operations
• Provides direction/oversight for financial, operational, and payer regulations as required for the Medicaid or other payers for Centering implementation at a new practice site
• Provides periodic summary reports to CHI leadership and Value-Based Care Specialist on payer landscape and regulations
• Performs various administrative and clerical duties to support the roles core function
• Performs all other duties as assigned

Project Responsibilities
• Provides vision and recommendations for growing CHI’s billing/coding support for clients
• Serve as primary advisor to and collaboratively with the Centering partner practice sites to ensure payer requirements are met in the most efficient and cost-effective manner
• Provides direction to Centering practice sites for implementation of regulatory and revenue requirements changes impacting the Centering practice site for billing and coding
• Occasional travel to Centering practice sites

Experience, Education, Skills and Abilities
• Certified Processional Coder Required (prefer at least one of the following credentials: CCS, RHIT, RHIA, CPC, COC)
• Experienced in performing Current Procedural Terminology (CPT) and International Classification of Diseases, volume 10 (ICD10) coding
• Has expertise with HCPCs procedural codes both from a private practice and Federally Qualified Health Center (FQHC) perspective
• Bachelor’s Degree in Healthcare Administration or Business (preferred)
• 3-5 years of progressive experience in medical coding, billing and reimbursement
• Experienced manager
• Ability to teach and train others in key billing/coding functions
• Strong project management skills
• Solid time management skills
• Excellent attention to detail
• Exceptional oral and written communication skills
• Superior interpersonal and collaboration skills
• Strong creative thinking and problem-solving skills
• Ability to multi-task and adhere to strict deadlines
• Capable of handling confidential information in a discrete manner
• Ability to work extended hours when deadlines are approaching

Work Aids and Equipment Used
Computer, printer, copier, scanner, fax, telephone, web conferencing.

Working Conditions
Work is sedentary in nature and performed in an office environment. Occasional travel to client and/or training sites. Involves frequent phone and email contact with staff and clients.

Physical/Mental Demands
Work requires hand dexterity for office machine operation; stooping, climbing, and bending to files and supplies; mobility to complete errands; stand/sit for up to eight hours each day; ability to communicate clearly when using the telephone; requires sitting; standing, walking, reaching, bending, lifting, and twisting at times; moderate levels of stress.

CHI actively seeks to build a diverse staff that is reflective of the populations we aim to serve and the communities where we work. CHI encourages multiple perspectives and experiences and strives to hire and retain a diverse workforce. Our employees are passionate, curious and eager for the challenge of changing healthcare.


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