Manager of Billing and Coding

 ABOUT US

For over 55 years, we have been considered one of the innovative world leaders in the enhancement and improvement of care for foot and ankle medical conditions, sports medicine and clinical programs. Our mission is to improve the quality of life in a patient focused environment by providing the most advanced and knowledgeable foot and ankle care. WFAI has experienced phenomenal development, with expansion into 5 states and a future dedicated to continuing with that growth strategy. As our family expands, we stand by our core values, which include integrity, excellence, trust, caring, tradition and innovation. 

Position Summary:
The Billing and Coding Manager plays a key role in contributing to our company’s mission, vision, and values by overseeing the billing and coding processes. This position ensures accuracy, compliance, and efficiency in revenue cycle operations. The manager will lead a high-performing billing and collections team, optimize workflows, and serve as a liaison between clinicians, operations, and Revenue Cycle Management (RCM) departments.

Key Responsibilities:

• Oversight of the Coding Team and claims billing process. 
• Educates physicians and clinical staff with up-to-date coding guidelines.
• Responsible for assessing coding and physician documentation with any potential acquisition and communicate the feedback with leadership. 
• Reviews and approves medical records requests. 
• Develops best practices to optimize coding practices. 
• Evaluates, hires, trains, and manages a team of certified medical coders and manages outsourced coding.
• Understands the complexity of and has oversight of all Health Plan and Regulator audits
• Works with both vendors and IT department for submission of data to Health Plans
• Stays up to date on federal and state regulations, and recommends changes regarding claims and billing requirements to keep organization compliant
• Responsible for security and accuracy of claims
• Communicates with Health Plans about coding errors.
• Contacts physicians and other health care professionals with questions regarding documentation of patient services and diagnoses as needed to resolve issues in order to submit clean claims
   

QUALIFICATIONS: 

• Bachelor’s degree in a work- related field/discipline from an accredited college or university
• Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC) with a minimum of five (5) years of experience with CPT/ICD-9/ICD-10 coding of providers services preferred.
• Seven (7) years of progressively responsible and directly related work experience
• Minimum three (3) years supervisory experience or demonstrated leadership ability required
• Knowledge of CMS regulations
• Knowledge of Podiatry and/or foot and ankle orthopedic surgery, wound care a plus. 
• Advanced knowledge of revenue cycle software systems
• Expertise in Medical terminology and various data elements associated with Medicare encounter and claims forms.
• Knowledge of state(s) and local and federal regulatory requirements
• Microsoft Excel, Work, and Access skills
• Detail oriented with excellent verbal and written communication skills.
• Demonstrates effective interpersonal, and organization skills.
• Ability to plan and identify opportunities to effectively utilize resources.
• Ability to lead and influence others.
• Excellent critical thinking skills
• Commitment to high level of customer service

TRAVEL:

• Travel may be required up to 20% locally or nationally.

BENEFITS:

• Medical
• Dental
• Vision
• Life Insurance
• Flexible Spending Account
• Healthcare Spending Account
• 401(k) Matching
• Paid Time Off
• Training Provided
• Pet Insurance
• Remote work

   PHYSICAL DEMANDS:

• Physical demands to successfully perform the essential functions of this job including but are not limited to walking, sitting, stooping, kneeling, standing, and crouching
• The employee must be able to regularly lift up to 10 pounds
• No specific vision requirements 
• No specific noise requirements

AMERICAN WITH DISABILITIES ACT (ADA) SPECIFICATIONS:

Qualified individuals with disabilities may request reasonable accommodation to the Director of Human Resources. Upon receipt of an accommodation request, the Director of Human Resources will meet with the requesting individual to discuss and identify the precise limitations resulting from the disability and the potential accommodation that might help overcome those limitations. The Director of Human Resources in conjunction with a medical review (and, if necessary, other appropriate management representatives) will determine the feasibility of the requested accommodation and the impact on the business operation. The Director of Human Resources will inform the qualified individual of the decision about the accommodation request or how to make the accommodation.