Medical Coding Program Manager

The Medical Coding Program Manager is a medical coding Subject Matter Expert responsible for managing complex, cross-functional projects and making recommendations to align with strategic goals. Responsible for services and related deliverables associated with medical policy, benefit administration, claims editing and other related areas. The Manager leads medical coding functions impacting core claims processing, payment policy and other internal departments as well as interacts with Plans to provide coding education to support local medical policy and internal processes. Ultimately, the role serves as a coding expert, assimilating trends and requested information into sound recommendations resulting in value-added resources for internal staff, Plans, and external customers.

• Research, review, and interpret clinical and industry coding literature, applicable federal regulations, contract requirements and standards of clinical practice. Stays abreast of all industry professional and facility code modifications, rules and regulations as released and identifies appropriate claims system classification, benefit assignment, as well as medical and pharmacy policy placement to ensure ac...