SNF Coding Manager

About the role

The coding manager will oversee the Post Acute Care service line and the post-acute coding methodology and serves as the senior subject matter expert (SME) for Skilled Nursing Facility (PDPM), Home Health (PDGM), and Long-Term Care (LTC). This role bridges sales and delivery to create compliant coding teams that meet client requirements. Think of this role like a Master Housing Contractor for post-acute coding: analyzing client needs, customizing design, drawing precise blueprints, coordinating with the building team, then building and refining the final structure — owning the full coding methodology from blueprint to delivery, ensuring accuracy, compliance, and optimal reimbursement, customized for each client’s needs. The role will not have direct reports for the foreseeable future.

Responsibilities

• Develop and maintain the master coding manual for SNF, HH, and LTC.
• Design standardized workflows, templates, query tools, checklists, and the enterprise audit scorecard.
• Perform Root Cause Analysis (RCA) when accuracy falls below 95%, and drive corrective action plans.
• Develop training curriculum and “Train-the-Trainer” programs for new CMS/payer changes.
• Serve as the go-to SME for complex coding gray areas and functional owner of coding software (Epic, CAC, AI tools).
• Partner with IT to optimize EHR templates and automated coding tools.

Requirements

• 5-10 years of progressive experience in medical coding, auditing, and compliance, specifically within any of the following areas: Skilled Nursing Facilities, Home Health, or Long-Term Care environments.
• Proven success in client-facing roles such as pre-sales support, solution architecture, or functional delivery leadership within a BPO/outsourcing context.
• Deep, hands-on knowledge of ICD-10-CM, CPT/HCPCS, MDS/RAI and PDPM models, OASIS-E and PDGM models, and survey readiness and documentation standards.
• Strong understanding of CMS regulations, payer policies, HIPAA compliance, and audit frameworks (RAC, MAC, ADR).
• Active AHIMA (CCS, RHIA, RHIT) or AAPC (CPC) credentials.

Qualifications

• CDIP, CCDS, CRC, COQS, or equivalent credentials are a plus.
• RN, PT, OT, or SLP licensure is preferred (not required).
• Knowledge of Inpatient Rehabilitation Facilities (IRF-PAI and CMG models).

Benefits

• Fully Remote Health, Vision, and dental coverage
• Long and short-term disability
• Paid time off (PTO)
• 401K with matching
• Annual merit increases
• Free continuing education units
• Life Insurance, HSA/FSA Plan
• Free educational webinars
• Bonus plan