System Manager, Coding

About the role

The System Hospital Coding Manager works closely with HIM and Revenue Cycle leadership to develop, implement, train, and monitor hospital coding policies and procedures. This role oversees coding and compliance, manages coding processes and EMR workflows, and ensures productivity and quality benchmarks are met.

Responsibilities

• Develops and monitors hospital inpatient and outpatient coding processes and EMR workflows
• Serves as the Health System's resident expert for hospital coding
• Prepares and supervises external audits
• Leads coding supervisors on internal auditing processes and audit systems
• Communicates with HIM and other UVMH staff to ensure compliant coding and billing practices
• Facilitates development, monitors, and ensures timely and accurate completion of all coding edits
• Acts as a content expert to communicate regulatory or operational coding issues to IS analysts, Revenue Cycle, Revenue Integrity, Compliance, and other relevant system department leaders
• Researches and stays informed about current and proposed regulatory information and coding guidelines
• Partners with System Director UR/CDI regarding the UVMH Clinical Documentation Improvement program
• Reviews the quality of coding functions and identifies process improvement needs
• Maintains policies and procedures that comply with all regulatory guidelines
• Serves on various committees to support UVMH Revenue Cycle and Compliance processes

Requirements

• Bachelor’s degree in HIM or related discipline
• Five years of coding leadership experience in a multi-facility health system (or equivalent combination of education and experience)
• One of the following active credentials required: CCS or CPC
• Strong understanding of clinical terminology, anatomy/physiology, pharmacology basics, and medical record documentation standards
• Demonstrated knowledge of ICD-10-CM, CPT, HCPCS Level II, modifiers, and official coding guidelines
• Working knowledge of payer policies (e.g., Medicare, Medicaid, commercial), medical necessity concepts, and denial prevention
• Familiarity with provider-based billing rules, rural health clinic (RHC) or federally qualified health center (FQHC) workflows, preferred

Qualifications

• Minimum of 5 years of progressive healthcare coding leadership experience in the hospital setting
• Prior work as a hospital coder is required