Manager, Hospital-Based Coding

In addition to the responsibilities listed below, this position is also responsible for managing the review of hospital-based coding for accuracy and completeness; monitoring feedback provided to hospital-based coders to foster continuous improvement; managing hospital-based coding teams; preparing and/or monitoring workloads; monitoring for adherence to hospital-based coding standards and industry regulations; guiding team members in implementing hospital-based coding productivity tools; proactively monitoring staff to ensure they stay updated on hospital-based coding guidelines and regulations; and fostering a collaborative work environment.

• Provides developmental opportunities for others; builds collaborative, cross-functional relationships. Solicits and acts on performance feedback; works closely with employees to set goals and provide open feedback and coaching to drive performance improvement. Pursues professional growth; develops and provides training and development to talent for growth opportunities; supports execution of performance management guidelines and expectations. Leads, adapts, implements, and stays up to date with organizational change, challenges, feedback, best practices, processes, and industry trends. Fosters open dialogue amongst team members, engages, motivates, and promotes collaboration within and across teams. Delegates tasks and decisions as appropriate; provides appropriate support, guidance, and scope; encourages development and consideration of options in decision making.


• Manages designated work unit or team by translating business plans into tactical action items; oversees the completion of work assignments and identifies opportunities for improvement; ensures all policies and procedures are followed. Aligns team efforts; builds accountability for and measuring progress in achieving results; determines and ensures processes and methodologies are implemented; resolves escalated issues as appropriate; sets standards and measures progress. Fosters the development of work plans to meet business priorities and deadlines; obtains and distributes resources. Removes obstacles that impact performance; identifies and addresses improvement opportunities; guides performance and develops contingency plans accordingly; influences teams to execute in alignment with operational objectives.


• Manages services related to documentation and coding compliance by: training and leading the team to support and leverage coding documentation and technology tools to ensure accurate coding in compliance with Official Coding Guidelines, ICD-CM, CPT, and HCPCS codes in the health care documentation system, and resolving any issues that arise; influencing the teams long-term planning in performing ongoing accurate documentation and coding of data, and ensuring outcomes are used to improve procedures; and guiding others to ensure compliance with applicable federal, state, and local laws and regulations, The Principles of Responsibility, the Code of Conduct for Kaiser Permanente, internal policies and procedures, professional standards, and accreditation standards.


• Monitors others updating coding processes and meeting regulatory goals by: owning the development and execution of new strategies for performing analysis/review to assure the accuracy of current procedures and diagnosis codes; planning for the implementation of systems, processes, and methods to maintain teams up-to-date knowledge of standards and regulatory requirements related to coding, documentation, and management compliance (federal, state, internal); developing strategies for updating reference materials requiring revision based upon changes in code sets, industry standards, or compliance with state and federal rules; and managing staff workflows and performance to ensure goals are met.


• Manages services related to data management and reporting by: ensuring team identifies and analyzes trends utilizing established documentation and coding criteria to support administrative planning and continuous improvement efforts; and managing team members collaborating to address team needs based on reported data analyses and plans of action.


• Manages medical coding procedures by: training, and/or identifying opportunities for training, teams on translating clinical information into appropriate codes for diagnoses, procedures, and other services rendered, following coding guidelines for the most current version of the International Classification of Diseases Clinical Modification (ICD-CM), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) Level II for patient encounters, and overseeing coding workflow; providing guidance to team members assigning appropriate codes for diagnoses, procedures, and other services rendered; driving the development and application of strategies for identifying and resolving coding issues through partnership with clinicians, department administration, and other coding staff based on review, coding guidelines, and queries or issues with practitioner-submitted medical codes to reduce denials and improve time to submission; and guiding teams consultation to staff and care providers on all coding and documentation questions, and defining issues for complex problems.