Full-Time Coding and Vendor Performance Manager

Vendor Performance Manager - Medical Coding and Billing leads vendor management in selecting, monitoring, and auditing third-party medical coding and billing vendors. This includes all aspects of the vendor management lifecycle, from initial selection and onboarding to ongoing performance monitoring, risk management, and contract compliance.

Ensures vendor compliance with:

• Coding accuracy standards
• Billing regulations
• HIPAA
• Contractual obligations
• Internal policies

Drives operational efficiencies and minimizes risk. Oversees vendor relationships, performance, and onboarding processes, focusing on the unique requirements of medical coding and billing services.

Responsibilities:

1. Vendor Management Oversight: Oversee all aspects of vendor management and vendor relationships. Lead and mentor staff in selecting, monitoring, and auditing vendors.
2. Coding and Billing Quality Monitoring & Reporting: Develop and maintain a system to monitor vendor coding accuracy, billing compliance, claim submission success, and adherence to client requirements. Create regular reports for senior management on vendor performance, compliance, service quality, and risk.
3. Compliance & Risk Management: Manage vendor compliance to regulations (HIPAA, ICD-10, billing regulations) and internal policies. Conduct periodic risk reviews of critical vendors, and prepare risk assessments for new and existing vendors.
4. Contract Management & SLA Compliance: Monitor and report on SLA compliance and contractual obligations.
5. Process Improvement: Review and analyze business processes to increase compliance and operational efficiencies.
6. Vendor Onboarding & Due Diligence: Oversee onboarding and due diligence according to company policy.
7. Vendor Complaint Management: Oversee vendor complaints and serve as the first point of contact.
8. Vendor Scorecard Management: Oversee the monthly scorecard review process, including performance analysis, action plans, and follow-up.
9. Communication & Escalation: Serve as the primary point of contact for vendor escalations.
10. Team Leadership & Development: Manage, mentor, and develop the vendor management team.
11. Document Management: Monitor and approve department forms, job aids, and documents.

Requirements:

• High School Diploma, Medical Office training certificate, or relevant experience
• 5+ years of experience in vendor management, with a strong focus on healthcare services
• Certified Professional Coder (CPC) or equivalent certification
• In-depth knowledge of medical coding and billing procedures (ICD-10-CM, CPT, HCPCS)
• Strong understanding of HIPAA regulations, data security, and compliance requirements
• Excellent analytical, problem-solving, communication, negotiation, and interpersonal skills
• Project management and organizational skills
• Experience with contract negotiation and management

Salary: $66,000.00 - $82,000.00 (base)

Bonus potential: 15% annual bonus, restricted stock units.

Technical Requirements (Remote): Minimum 5 Mbps download speed, 3 Mbps upload speed.

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