Our mission is to improve the quality of care and reduce the overall cost of healthcare by making the decision-making process more data driven. Our products will have an impact on the national healthcare infrastructure and you will play a significant role in it.
We are building a big data platform for complex healthcare data, both discrete and unstructured. We apply to this data different processing techniques, including natural language processing and inference, to produce clinical and financial insights that result in better quality care for patients and improved financial performance for healthcare organizations. We are also building a suite of applications that can utilize the power of this platform and deliver true end user solutions.
About the Job:
The Manager of Coding Operations is responsible for assisting in the development, evolution and implementation of our overall coding products and services. The manager will work with Product Managers and key stakeholders to define and construct content and workflow rules to support Health Fidelity’s NLP-enabled risk adjustment coding solution. The manager will provide oversight for the Coding section serving as a resource to leaders, co-workers and customers on coding and documentation standards and regulations.
The coding manager will conduct trend analysis, audits and internal investigations to monitor program compliance and initiate corrective action plans where appropriate.
The Manager of Coding Operations will report to the Director of Coding Operations and will oversee a team of 2 coders as well as contract staff and Vendor management.
- Provides direct managerial oversight to the Health Fidelity, contract coders and vendors to include quality coding reviews and education
- Selects, evaluates, trains, and provides leadership and direction to reporting staff
- Coaches and helps develop team members; promotes teamwork within functional area(s); disciplines and coach staff as necessary
- Identify common clinical descriptions and semantics for various diagnostic terms and statements. Help apply the currently prescribed coding rules to best match up with these descriptions.
- Create, define and implement NLP rules to improve Recall and Precision.
- Provide subject matter expertise for client implementations and training
- Work with NLP informaticists to define NLP rules and articulate coding rules and conventions (rules for combined codes, inclusions, exclusions, etc.) in a meaningful way
- Articulate the understanding of clinical documentation and coding workflow for the software developers
- Conduct iterative QA and testing of NLP-assigned codes providing feedback to the development team
- Communicate changes, enhancements and modifications verbally and through written documentation
- Work with product designers to identify requirements for user interface, features and functionality of the risk adjustment platform and other coding-related software products
- Create diagrams and flow charts to help developers understand the workflow for clinical documentation review and code assignment
- Position may require minimal travel for in-person team strategy and planning sessions, and in-person client meetings as needed
- Other duties as assigned
- Bachelor’s degree or equivalent experience
- Minimum 2 years of health care management/leadership required
- Minimum of 5 years of coding experience
- Graduate of an AHIMA or AAPC certified coding program, CCS or CPC required
- Background in Computer Science/IT/SQL
- Advanced Microsoft Excel skills
- AHIMA-Approved ICD10 Trainer or AAPC ICD10 Certificate
- Risk adjustment coding experience helpful
- Experience in analyzing data
- Strong troubleshooting and problem solving skills
- Some familiarity with SNOMED CT ontology, or other structured medical terminologies
- Excellent knowledge of coding guidelines and conventions
- Experience with coding QA and education required
- Excellent organizational, analytical, verbal and written communications and interpersonal skills
- Ability to work in a fast paced, customer oriented environment. Possess a “do what it takes” attitude and a strong work ethic.
- Must be self-directed, willing to work independently and comfortable taking the lead on resolving issues that span multiple groups or team members
- AHIMA RHIA or RHIT credential
- AHIMA Certified Health Data Analyst (CHDA) credential
- 3-5 years IP/OP coding audit experience
- Experience with RADV or RAC audit processes
- Experience with clinical documentation improvement requirements
- ICD-10-PCS and CPT coding helpful
- Duties may require minimal travel (<25%) to team meetings or customer meetings
Position will be based in our office in Pittsburgh, PA.
Please apply on our website: https://healthfidelity.com/careers/
Thank you for your interest in Health Fidelity.