I. JOB SUMMARY

The Coding Operations Manager ensures the accuracy, efficiency, and compliance of coding

and billing operations within ADEC Healthcar. They lead a team of medical coders and work

closely with other departments, including finance and compliance, streamline processes,

maintain up-to-date coding practices, and ensure adherence to relevant regulations (e.g., ICD-10, CPT, HCPCS).

The manager is responsible for optimizing the workflow of coding operations, conducting regular audits, identifying issues, and implementing improvements to enhance productivity and reduce coding errors. They are expected to abide by the Standards of Ethical Coding as set forth by AHIMA.

II. DUTIES AND RESPONSIBILITIES

1. Supervise, train, and develop a team of medical coders and billing specialists. Provide

support for their professional growth and address any performance issues.

2. Ensure the accuracy and compliance of medical codes for billing and insurance purposes.

Perform regular audits to assess the quality of coding, reduce errors, and ensure timely

submission of claims.

3. Monitor and optimize coding workflows, processes, and systems to improve operational

efficiency. Ensure adherence to coding standards and government regulations.

4. Work with other departments (e.g., billing, finance, compliance, and IT) to resolve coding-

related issues and implement changes to improve revenue cycle management.

5. Prepare and present reports on coding productivity, quality metrics, and any issues that

affect revenue cycle performance. Analyze trends to ensure continuous improvement.

6. Stay updated on coding changes, regulatory standards, and industry best practices.

Ensure compliance with HIPAA, CMS, and other relevant regulations.

7. Address and resolve any coding-related issues, disputes, or claim denials. Develop and

implement corrective action plans where needed.

8. Leverage coding software and electronic health records (EHR) systems to improve

accuracy, efficiency, and data management.

9. Maintains and secure data and all individually identifiable personal information accessed

through the client’s and/or ADEC’s systems to safeguard confidentiality of data.

10.Utilizes the appropriate system required for the program to gather information and answer

program specific questions relevant to scope of work that will ensure accurate information

dispensed or provided to the team being supported.

11.Participates in continuous learning business methodologies and programs in order to

develop proficiency in scope of work.

12.Ensures compliance to company rules and regulations, which shall include but not limited to

the Employee Code of Discipline, the policies on Quality Management System (QMS),

Information Security Management System (ISMS), Environment Health & Safety (EHS),

and Environmental Management System (EMS), Data Privacy Act (DPA); and other duties

and responsibilities prescribed for all ADEC employees.

13.Ensures compliance of all Non-Conformity Corrective Action Preventive Action

Concessions (NCAPACs) and all other audit findings within the prescribed period.

14. Reports security incidents and/or any identified security weaknesses.

15. Performs other tasks that may be assigned from time to time.

III. JOB REQUIREMENTS

Education ▪ Bachelor’s degree in health information management or related Allied Health discipline.

▪ Master’s degree is preferred

Experience ▪ At least 5 years of experience in medical coding or revenue

cycle management, with a minimum of 2 years in a

supervisory or managerial role.

▪ Strong understanding of coding systems (ICD-10, CPT,

HCPCS), excellent leadership and communication skills,

proficiency with coding software and EHR systems.

Eligibility

(Training, License,

Certification)

▪ Certified Professional Coder (CPC), Certified Coding

Specialist (CCS), or similar credentials preferred.

Competencies

(Knowledge, Skills,

Attitudes)

Functional Competencies

▪ Intermediate technical credibility. Able to adapt and meet some complex or non-routine situations

▪ Basic results orientation and accountability. Checks on own work to ensure all steps are completed accurately, takes action to correct substandard work, and takes pride and

ownership in one's work

▪ Basic critical thinking. Identifies sources of data and information, and learns where to find the most relevant information for solving problems

▪ Basic problem solving and decision making. Asks appropriate questions to define decisions to be made

▪ Basic organizational awareness. Understands and uses the organization's structures, rules, networks, processes, methods or operations to achieve results

▪ Basic external awareness. Keeps oneself updated of developments in other parts of the organization; and exhibits awareness of external realities