Senior Medical Coder

Mpower Talent Solutions San Antonio , TX 78216

Posted 2 months ago

Position Summary:

Responsible for planning, organizing, and directing the operation, training, quality, support services and administration of the Accurate Coding Initiative (ACI) department to ensure that the coding processes for record reviews are conducted in a timely manner to meet company and regulatory standards. The individual coordinates departmental duties with appropriate personnel to meet needs of the department, ensures compliance with state and federal requirements, CMS guidelines. Develops and implements policy and procedures; updates and integrates the medical management departments as able to improve efficiency; performs employee counseling, performance appraisals, and oversights employee training and development. The success of this position requires the ability to foster communication and teamwork between physicians, clinic staff, medical management staff, corporate departments, and senior leadership. The individual provides long-term planning and oversight to maintain operations of the department assuring activities are appropriately integrated into the strategic direction, as well as the mission and values of the company.

Minimum Required Education, Experience & Skills

  • Bachelor's of Science in Nursing required.
  • Current Registered Nurse (RN) licensure required.
  • Five or more years of clinical RN experience with at least 3 years of ICD-9 diagnostic coding and supervisory experience required.
  • Strong knowledge of ICD-9 coding processes with excellent analytical and data mining skills required.
  • Ability to effectively manage projects, plan and implement programs and evaluate outcomes required.
  • Ability to effectively report data, facts and recommendations in oral and/or written form required.
  • Ability to analyze facts and exercise sound judgment when arriving at conclusions required.
  • Ability to effectively manage and direct various levels of staff required.

Preferred Education, Experience & Skills

  • Previous medical coding operations management experience preferred.
  • Certified Professional Coder (CPC) certification preferred.
  • Master's Degree in Nursing or related field preferred


  • Provides day-to-day oversight of operations for the ACI department.
  • Hires staff for all markets and assures adequate staffing is in place to meet market demands
  • Maintains, revises and implements the medical record review processes and resource/reference tools.
  • Coordinates educational training sessions for market Primary Care Physicians and their staff to ensure federal and regulatory compliance, as well as coding and documentation compliance.
  • Provides monthly reports to senior management.
  • Monitors staff compliance in regard to ACI departmental policies and procedures to ensure quality outcomes for the company.
  • Monitors and maintains staff productivity and coordinates training for new and existing employees.
  • Identifies process improvement opportunities for ACI team to ensure quality outcomes in ICD-9 coding and overall ACI process.
  • Provides employee coaching, counseling and evaluation of performance through periodic and annual reviews.
  • Develops training programs and coordinates training needs for ACI team, new employees and providers and other clinic staff as necessary.
  • Assists IS/ DBA with new development and maintenance of the audit application and quality upgrades to the application on an ongoing basis to ensure efficiency in production for clinical coding staff.
  • Assists IS/DBA and the Clinical Research departmental with data mining efforts in recruitment process for clinical research studies
  • Develops and implements objective quality program that ensures compliance with CMS and ICD-9 coding requirements and administers the program in a professional, objective manner as well as ensuring inter rater reliability.
  • Performs all other related duties as assigned.


See if you are a match!

See how well your resume matches up to this job - upload your resume now.

Find your dream job anywhere
with the LiveCareer app.
Download the
LiveCareer app and find
your dream job anywhere

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Medical Coder 1

Engility Corporation

Posted 1 week ago

VIEW JOBS 11/2/2018 12:00:00 AM 2019-01-31T00:00 The primaryduties are to review clinical documentation & assign medical codes foroutpatient clinic facility and/or professional services. * Make well-informed decisions, evenwhen data is limited or solutions produce unpleasant consequences * Receive & respond to verbalmessages & cues such as body language in ways that are appropriate * Utilize medical computer softwareprograms to abstract, and/or evaluate clinical documentation & enter/editdiagnosis & procedure codes. * Write in a concise & convincingmanner for the intended audience; which may include technical material * Display, courtesy & tact, abilityto effectively develop and maintain relationships and work with individuals ofall backgrounds. * Work with internal/external customersto assess needs, provide information or assistance, resolve their problems, orsatisfy their expectations. * Be open to change & newinformation; adapt behavior or work methods in response to new information& changing conditions * High level of effort & commitmenttowards performing the work, using efficient learning techniques toacquire/apply new knowledge and skills * Understand & interpret writtenmaterial, including technical material, rules, reports, charts, graphs, ortables; applies what is to specific situations. * Attention to detail &completeness with a thorough understanding of government rules &regulations, medical coding & reimbursement guidelines, & potentialareas of risk for fraud. * Use imagination to develop insightsinto situations & apply new solutions to problems; assist in designingmethods where established methods and procedures are not suitable or areunavailable. Education, minimum ofone of the following: * An associate's degree in HealthInformation Management; OR * A university certificate in medicalcoding * At least 30 semester hours'university/college credit that includes relevant coursework such as anatomy/physiology,medical terminology, health information management, and/or pharmacology; OR * Successfulcompletion of Academy of Professional Coders (AAPC) or American HealthInformation Management Association (AHIMA) coding exam preparation courses thatinclude the above coursework & lead to successful course completion &coding certification may be accepted in lieu of university/college credit bythe AFMS MCPO AND Certification in goodstanding for each: a)Professional Services Coding Certifications: Registered Health InformationTechnician (RHIT); Registered Health Information Administrator (RHIA);Certified Professional Medical Coding Auditor (CPMA); Certified ProfessionalCoder (CPC); Certified Outpatient Coder (COC); or Certified Coding Specialist -Physician (CCS-P). b) Continuing Education Requirements: Medicalcoders shall maintain the required continuing education hours in order tomaintain current & proper national certification(s) requirements for thisposition at no expense to the Government. AND Experience - * Min.of 5 yrs. of medical coding and experience in 2 or more medical or surgicalspecialties within the past 10 yrs., OR * Min.of 3 yrs. Ambulatory Procedure Visit (APV) coding experience within the last 6yrs. in a military coding environment. * Min.of 1 yr. of performance in the specialty is required to be qualifying. CodingTest - Pass a pre-employment coding test IAW therequirements of the AFMS Coding Manual Engility Corporation San Antonio TX

Senior Medical Coder

Mpower Talent Solutions