Manager, Coding Operations (Certified Coder)
Who We Are:
At Cityblock Health, our mission is to radically improve the health of urban communities, block by block. We integrate services to address physical, behavioral, and social needs together, delivered at community hubs and through field-based care teams to make healthcare more accessible, supportive and goal-driven for the people who need it most.
Every aspect of the Cityblock care model is carefully designed to focus on our members, engaging and empowering them to own and improve their health through trusted relationships. Through mobile interdisciplinary care teams, we are flexible in how we deliver care, meeting members where they are, and together developing and working longitudinally through a personalized and integrated Member Action Plan (MAP). The care team collaborates to support each member’s whole health and social needs. Enabled by custom-built technology, we build capacity, deliver care and dramatically change members’ opportunities and outcomes.
Partnering with community-based organizations and a well-respected commercial partner in New York, and backed by the top healthcare investors in the country, we are reorganizing the health system to focus on what matters to our members—and leading the move from transactional, fee-for-service medicine towards high-value, relationship-based partnerships.
As the Manager, Coding Operations you will play a critical role in creating a culture of best-in-class clinical documentation accuracy in support of building a model of care focused on best quality and health outcomes. You will leverage your coding and documentation expertise to foster improvements in quality of care, analytics and clinical coding. This will involve, but not be limited to, creating audit protocols and conducting audits, developing training and creating reference materials for documentation, aligning performance with incentives and rewards, and establishing relationships with clinicians and market leaders.
- Serve as the subject matter expert on ICD-10-CM coding guidelines
- Develop, and implement, ongoing concurrent, and retrospective, coding and documentation review program
- Probe clinicians when code assignments are unclear or documentation is inadequate or ambiguous
- Report any discovered documentation and/or coding errors or noncompliance with stated policy, rules, guidelines and other coding processes to management. Follow up with clinicians to obtain missing or incomplete information
- Accurately maintain electronic files and logs of all completed documentation and coding reviews, as well as accurately maintain original records of all received supporting documentation.
- Effectively communicate all requests for additional, or clarification, of information to the appropriate clinicians and/or management staff.
- Support coding vendor; ensure coding is being accurately, consistently and reliably performed in a timely manner
- Develop documentation guidelines, including condition-specific quick reference tools
- Conduct ongoing education and training on proper documentation and coding
- Develop documentation and coding metrics, and incorporate into annual performance management process
- Develop appropriate incentives, recognition and reward system to recognize achievement of performance metrics
- Develop contacts and relationships throughout CBH, and its vendors, to drive consistent improvement in documentation and coding practices.
- Engage with market teams to be informed of regional, market, or plan-specific issues, and key areas of focus
- Prepare and disseminate reports outlining performance, opportunities for improvement and action plan(s), as appropriate.
- Maintain professional credentials
You’d be a good fit if:
- You are ICD 10 Coding certified
- You have 5+ years of medical coding experience
- You have 5+ years experience working in a primary care practice or performing a coding function at a Medicare or Medicaid health plan or vendor that supports those health plans
- You have experience with multiple EMR systems
- You have great attention to detail and audit experience
- You’re skilled at using KPI dashboards and other data to drive initiatives
- You are interested in advancing innovative models of care
- You can effectively build relationships and collaborate with coworkers and clinicians
Nice to have:
- Active RN license
You should include these in your application:
- A resume and/or LinkedIn profile.
Cityblock values diversity as a core tenet of the work we do and populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.