Position: Supervisor, Clinical Data/Medical Coding

Department: Insurance Billing, Revenue Cycle
Location: United States, Remote

About This Role:
In this key leadership position, you'll oversee a team of Clinical Data Specialists/Medical Coders, their duties, and processes within our rapidly growing, mission-oriented organization. This team is responsible for reviewing pre-claims for ICD-10 code discrepancies and using clinical charts to update or seek additional diagnosis information. Your leadership will drive the development of operational details behind the team's success, and your contributions will foster accurate outcomes, supporting our broader goal of impacting global healthcare delivery and excellence. You will play a crucial role in ensuring compliance with healthcare regulations and maintaining the integrity of our billing and coding processes.

Responsibilities:

• Perform quality checks on team member work to ensure exceptional accuracy levels and compliance with healthcare regulations
• Establish and maintain tracking tools for managing and capturing coding errors, adhering to HIPAA and other relevant privacy laws
• Provide real-time support to team members facing internal or external challenges, including compliance-related issues
• Advise and promote productive personal credit resolution efforts in accordance with Fair Credit Reporting Act (FCRA) guidelines
• Collaborate with colleagues to synthesize and report on team efforts and statistics, ensuring data privacy and security
• Partner with other departments to ensure seamless integration of billing and coding processes while maintaining regulatory compliance
• Stay updated on changes in healthcare regulations and implement necessary adjustments to team processes
• Additional responsibilities as needed to support team and organizational goals while maintaining legal and ethical standards

Qualifications:

• Proven experience in managing a remote team, specifically within insurance billing and medical coding
• Strong understanding of healthcare regulations and compliance requirements, including HIPAA, HITECH, and CMS guidelines
• Bachelor's degree in Health Information Management, Healthcare Administration, or related field (or equivalent experience)
• Relevant certifications in medical coding or billing (e.g., CPC, CCS, RHIA) required
• Knowledge of healthcare fraud and abuse laws, including the False Claims Act and Anti-Kickback Statute

Skills:

• At least 3 years in leadership and team management
• Quality assurance and attention to detail
• Problem-solving and decision-making
• Interpersonal communication and collaboration
• Data analysis and reporting
• Proficiency in medical coding and billing software and thorough knowledge of billing processes
• Adaptability and resilience in a fast-paced environment
• Ethical decision-making and compliance management
• Risk assessment and mitigation in healthcare billing practices

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