Orthopedic Coding Manager

Alteva RCM | USA Only

완전히 원격 풀타임 데이터 과학 및 분석
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설명

Headquarters:

URL: https://www.altevarcm.com

About Us

At Alteva RCM, we're dedicated to helping healthcare providers thrive through expert revenue cycle management, strategic insight, and innovative solutions. We're always looking for passionate, driven professionals who want to make a meaningful impact, grow their careers, and be part of a collaborative team committed to excellence.

Position Summary

The Orthopedic Coding Manager provides direct operational and people leadership for an team of coders in the surgical orthopedic speciality. This role has front-line accountability for the daily performance, accuracy, and productivity of their team, and serves as the primary escalation point for complex coding, documentation, and payer-related issues raised by Team Leads and coding staff. The Manager ensures coding accuracy, productivity, and compliance with applicable regulatory and payer requirements for their team, while partnering with Billing, Clinical, and Compliance teams to support clean claim submission, reduce denials, and protect revenue integrity.

Key Responsibilities

Team Leadership & Development

• Lead, coach, and develop the members assigned to their team

• Allocate work across their team based on complexity, volume, specialty, and individual capacity

• Support recruiting, onboarding, and competency validation for new and existing team members

• Establish clear performance expectations and conduct regular evaluations aligned to quality and productivity standards for their team

• Address performance gaps within their team through structured coaching and corrective action plans as needed

• Conduct regular operational reviews with each direct report to assess capacity, performance, backlog risk, compliance risk, education effectiveness, and cross-functional blockers

Escalation Management

• Serve as the primary escalation point for their team on complex coding scenarios, documentation concerns, payer conflicts, and account-level issues that exceed Team Lead or Associate-level resolution

• Resolve escalated coding questions in alignment with official coding guidelines and payer requirements

• Track escalation volume, trends, and resolution time for their team; identify recurring issues and implement targeted coaching and suggest workflow adjustments when needed

• Escalate systemic, high-risk, or unresolved issues to the Senior Medical Coding Manager with clear documentation and recommended next steps

Operational Oversight

• Oversee day-to-day coding operations for their team to ensure timely completion of encounters and consistent application of coding standards

• Ensure appropriate work distribution across their team based on complexity, volume, and individual capacity

• Monitor backlog levels and risks within their team; escalate issues with data-backed recommendations to the Senior Medical Coding Manager

• Maintain team-level adherence to departmental policies and procedures consistent with official coding guidelines and payer requirements

Compliance & Audit Oversight

• Oversee coding audits for their team, ensuring timely response, documentation support, and completion of corrective actions

• Monitor their team's adherence to coding rules, including documentation requirements

• Maintain audit-ready processes for their team and participate in compliance initiatives, education, and reporting

Revenue Cycle & KPI Management

• Monitor their team's KPIs, including coding quality scores, productivity, and turnaround times

• Partner with Billing and Revenue Cycle teams to support clean claim submission and reduce coding-related denials originating from their team

• Identify trends impacting reimbursement (e.g., documentation gaps, modifier usage, payer edits) within their team and implement targeted improvements

Cross-Functional Collaboration

• Partner with providers, clinical leadership, and compliance to promote complete and accurate documentation for encounters coded by their team

• Partner with the Coding Director and Coding Senior Manager to prepare and document Alteva coding guidance, coding rules and nuances related to assigned specialties

• Ensure coding LOA alignment and provide education to authorizations team when needed

Key Performance Indicators

• Team coding accuracy rate (target: 98%+)

• Productivity per coder against established benchmarks

• Turnaround time compliance by specialty/service line

• Escalation volume trend and escalation resolution time for their team

• Audit finding rate and corrective action closure timeliness

• Denial rate attributable to coding errors within their team

Experience & Requirements

• High School Diploma or equivalent required; Bachelor's degree preferred.

• Minimum of 7 years' experience in complex Orthopedic (Hand, foot, ankle) coding

• Minimum of 3+ years in a leadership or management role.

• Strong understanding of billing, coding (CPT, ICD-10), and payer guidelines.

• Proven track record of driving revenue performance and improving operational outcomes.

• Experience managing client relationships in a healthcare or revenue cycle environment.

• Strong analytical skills with the ability to interpret data and translate insights into action.

• Advanced proficiency in Microsoft Office applications (especially Excel) and reporting tools.

• Excellent communication, leadership, and interpersonal skills.

• Demonstrated ability to manage multiple priorities in a fast-paced environment.

Additional Qualifications

• Strong leadership presence with the ability to influence, motivate, and develop high-performing teams.

• Strategic thinker with a results-driven and revenue-focused mindset.

• Ability to collaborate cross-functionally and influence stakeholders at all levels.

Pay Range
$100,000—$125,000 USD

 

Benefits

Alteva RCM offers our employees a comprehensive benefits package, including health, dental, vision, employee assistance plan, paid family leave, short-term disability and life ins

필요한 기술

Compliance, Data Analysis, and Performance Management

작업 세부 정보

경험: 0 년

게시됨: 1 hour, 42 minutes 날짜

보기: 3

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