Manager Professional Billing Coding Operations

Responsibilities

• Manage the day-to-day operations of the Professional Billing Coding Operations Team
• Supervise, mentor, and develop a group of certified professional coders
• Validate the accuracy of CPT, HCPCS, and diagnosis code assignments
• Perform quality assurance reviews of inpatient and outpatient records
• Review coding denials to identify trends and provide feedback to providers
• Partner with the Coding Education Team to design and implement training programs
• Ensure compliance with Official Coding Rules, Regulations, and payer guidelines
• Oversee coding edits and support external coding reviews such as RAC

Requirements

• Bachelor's degree or equivalent combination of education and experience
• CPC (Certified Professional Coder) certification required
• Minimum of five years of coding experience including education/mentoring/training
• Minimum of three years of management experience required
• Experience in acute care hospital coding with ICD-10-CM and CPT-4
• Strong knowledge of E&M coding, medical terminology, and anatomy
• Proficiency in computerized billing systems and Microsoft applications

Preferred Qualifications

• Experience in an academic medical setting or trauma center
• Prior experience working with claim edits and denials

About the Company

Boston Medical Center (BMC) is a leading provider of trauma and emergency services in New England. As a large safety-net hospital and primary teaching affiliate of Boston University School of Medicine, BMC is committed to providing exceptional, equitable, and accessible health services to the community.