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Medical Coder Team Leader- Insurance Operations SFM The Work Comp Experts Work somewhere you love Since 1983, our mission has been to be the workers compensation partner of choice for agents, employers and their workers. SFM is unique in that we are small enough that your voice is heard, but has all the benefits and perks of a larger employer. We value your opinion, help you reach your goals, and make it easy for you to maintain work-life balance. Though much has changed through the years, our focus continues to be unrivaled customer service, safety, and providing better outcomes for employers and injured workers. SFM is an employee centric organization, and we believe that your success is our success. Benefits include a flexible work environment, health/dental insurance that includes supplemented dependent care coverage, generous PTO, student loan payback, a bonus program, 401k with match and much more!! Being able to work in a collaborative environment is key to being successful at SFM. We believe that our exceptional and motivated employees are our greatest strength, and we are committed to creating the best work environment. Apply today and discover why SFM employees choose to stay!! Our benefits include: Affordable Medical, Dental, Vision Insurance, HSA, FSA Traditional and Roth 401(k) plans with company match Company contributions to help pay off student loans Monthly home internet allowance Free life insurance, STD & LTD Opportunities for annual gainshare bonus Pet insurance Generous PTO 9 paid holidays Paid parental leave Annual company-wide volunteer day Adoption financial assistance Visit our careers page to learn more about working at SFM. The role As the leader of the Medical Support Reps, you will lead and manage a team of bill coders to successfully achieve business objectives and meet team goals. The team handles medical bills from the payor side of the business making sure the injured workers medical bills are paid correctly. As you Lead the team, you will seek out and implement process improvements to increase efficiencies and maintain or improve service results. Monitoring workflow, guiding training and conducting regular conversations with you team to ensure they are successful is a key function in this role. As a leader, you will provide direction to your team members by overseeing workloads, conducting performance reviews and inspiring others to do their best work while communicating the Organization s vision and expectations. This is a hybrid role, so some office time is need. What You Will Be Doing 1. Identifies improvement opportunities and keeps abreast of mandated rules, procedures, and forms. This includes development of expertise in business processes and bill review handling in core states. Communicates modifications and recommendations as needed. 2. Works in collaboration handling bill review software vendor and develops a working knowledge of all SFM business rules added to the vendor bill review system and attends meetings as needed to review service/quality issues. . 3. Proactively meets with the various business teams to ensure the medical services representatives are following the internal policies, practices and procedures, workflow/service issues are managed correctly. Maintains appropriate interactions with persons both within the organization and externally. 4. Works with PPO networks and research s other medical cost savings tools and services and makes recommendations for areas of improvement. 5. Participates in industry associations and conferences related to bill review functions. 6. Works with the analyzation and creation of bill payment documentation. 7. Handles complex and escalated medical billing/coding issues, complicated requests, complaints, and unique service issues. 8. Researches, analyzes, and updates ICD, CPT, HCPC and DRGs as needed. 9. Directs and schedules meetings related to medical support representatives activities and participates in special projects. 10. Creates a d analyzes staff audit reports and reviews bills processed by staff which may be used as part of their performance. 11. Monitors the various business queues to determine the efficiencies of the queues and analyzes the workflow needs to develop expectations for staff. 12. Stays current on workers compensation statutes and rules for all SFM jurisdictions and ensures that the vendor has incorporated changes as needed. 13. Uses latest technology and relies on best practices to identify, develop, and implement business solutions to improve business needs and training materials. 14. Audits files and identifies training issues through the use of regular questions and routine dialogue and measures overall medical support team results against defined success measurements. 15. Attends medical conferences at MN DOLI as needed to defend SFM billing decisions and assists with disputes that may arise in other states of operation. Leadership and Team Member Development 1. Develops and communicates vision and expectation levels to team members and relates them to corporate vision and strategic direction. Maintains appropriate interactions with persons both within the organization and externally. 2. Provides team members with the tools needed for the team to accomplish stated objectives and fosters a positive and rewarding work environment and monitors team dynamics and safety practices. 3. Consistently provides feedback and communication to staff members related to company and team performance. 4. Leads team members to make decisions based on established criteria/goals and monitors performance to achieve successful results. 5. Defines and develops team member s job, responsibilities, and accountabilities, in both a physical and virtual environment. 6. Selects, coaches, and retains staff. Inspires team members to attain goals and pursue excellence while identifying opportunities for improvement and provides constructive suggestions for improved performance. 7. Partners with and uses Human Resources as a resource for talent acquisition, training, and performance management. 8. Provides training and development opportunities. Identifies and develops future leadership within the team. Challenges team members to develop professionally or as leaders while serving as a role model and mentor. 9. Reviews team job descriptions and duties on a regular basis and makes adjustments as business requirements change. Ensures that proper cross training occurs to cover for volume peaks and team PTO. Business Operations: 1. Develops and applies team policies, practices and procedures and seeks opportunities to improve strategies that impact the business. 2. Seeks opportunities to improve upon or develop processes that could be used to enhance the service provided to agents, policyholders, injured employees and internal customers. 3. Develops and implements document retention policies, and partners with the Compliance team to ensure company business rules are adhered to. 4. Identifies, develops and implements business solutions to business needs and special projects and may include a heavy emphasis on technology, including working closely with IS staff on system development from a user perspective and seeks ways to improve efficiencies and improvements within the Team. 5. Identifies and implements policies, practices and procedures and communicates these best practices to the Insurance Operations team and ensures operational compliance with best practices and quality assurance standards.