Coding Manager

About the role

The Manager, Coding and Revenue Integrity (RI) oversees all aspects of day-to-day coding operations, coding education, and RI functions. Key responsibilities include planning, monitoring, updating, and directing coding, RI audits, and charge capture. This role also manages the coding and RI department staff, creates and oversees internal audit plans, disseminates and educates on coding, billing, and documentation guidelines, stays updated on coding and RI technology, establishes charge reconciliation procedures, and provides education for providers and RCM staff.

Responsibilities

• Demonstrates excellence in leading and controlling functional performance, measuring and improving processes, and continuously improving performance.
• Maintains and monitors charge capture across the organization, ensuring timely clean claims processing and avoiding late charges.
• Builds a collaborative team culture and ensures high employee engagement and satisfaction.
• Supports the Director in providing operational oversight for all Revenue Integrity functions, including charge capture, coding, and charge reconciliation responsibilities.
• Maintains system reports and monitoring tools to track payer denials and appeals, and develops and monitors KPIs related to charging practices.
• Interviews, hires, staffs, performs performance management and development of staff, counsels and disciplines employees as needed, and participates in audits and appeals with insurance carriers.
• Works closely with Patient Financial Services and Patient Access Departments, maintaining strict confidentiality and adhering to HIPAA guidelines.

Requirements

• Minimum of Associate’s degree in health information management, medical records administration, health services administration, or related field.
• CPC - Certified Professional Coder certification required.
• Five (5) years professional fee coding experience required.
• Minimum three (3) years of experience in leadership required.
• Two (2) years of audit management experience preferred.
• Proficient understanding of revenue cycle operations, including front, middle, and back-end processes.
• Experience in assisting and identifying learning needs, providing education, and training.
• Strong analytical and problem-solving skills.
• Knowledge of reimbursement methodologies, including professional coding and charge issues, and familiarity with ICD-10 and CPT/HCPCS coding guidelines.
• Basic knowledge of medical terminology, anatomy, physiology, clinical procedures, and diseases, and understanding of clinical documentation.
• Maintain strict confidentiality and adhere to HIPAA guidelines.

Qualifications

• Exemplary self-management skills.
• Excellent verbal and written communication skills.
• Demonstrated experience with interpreting and following detailed policies.
• Ability to organize and set priorities to meet objectives.
• Ability to adapt to change and handle challenges proactively.
• Ability to collaborate with physicians and managerial staff at all levels.