Full-Time Coding and Vendor Performance Manager

Vendor Performance Manager - Medical Coding and Billing leads the vendor management team in implementing and managing a formalized process for selecting, monitoring, and auditing third-party medical coding and billing vendors. This includes overseeing all aspects of the vendor management lifecycle, from initial selection and onboarding to ongoing performance monitoring, risk management, and contract compliance. This role ensures vendor compliance with coding accuracy standards, billing regulations, HIPAA, contractual obligations, and internal policies, while driving operational efficiencies and minimizing risk. The Manager will also oversee vendor relationships, performance, and onboarding processes, specifically focusing on the unique requirements of medical coding and billing services.

Responsibilities:

• Vendor Management Oversight: Oversee all aspects related to the Vendor Management department and third-party medical coding and billing vendor relationships.
• Coding and Billing Quality Monitoring & Reporting: Develop and maintain a system for monitoring vendor coding accuracy, billing compliance, and claim submission success.
• Compliance & Risk Management: Manage vendor compliance with regulatory requirements (HIPAA, ICD-10, billing regulations) and internal policies.
• Contract Management: Monitor SLA compliance and contractual obligations.
• Process Improvement: Proactively review processes related to medical coding and billing vendor management.
• Vendor Onboarding & Due Diligence: Oversee vendor onboarding.
• Vendor Complaint Management: Oversee and monitor vendor complaints.
• Vendor Scorecard Management: Oversee monthly vendor scorecard review.
• Communication & Escalation: Serve as the primary point of contact for vendor escalations.
• Team Leadership & Development: Manage, mentor, and develop the vendor management team.
• Document Management: Monitor and evaluate department forms and documents.

Requirements:

• High School diploma or equivalent
• 5+ years of experience in vendor management, healthcare services.
• Certified Professional Coder (CPC) or equivalent certification
• In-depth knowledge of medical coding and billing procedures
• Understanding of HIPAA regulations, data security, and compliance requirements
• Strong analytical, communication, negotiation, and interpersonal skills
• Project management and organizational skills
• Experience with contract negotiation and management

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