Coding Manager - Epic Professional Billing

Huron Consulting Services•Chicago, IL

2d•Remote

About The Position

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you’ll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise. The US Professional Coding Manager is responsible for the day-to-day operations and oversight of multi-shore professional coding services processes to ensure timely, accurate, consistent and compliant assignment of diagnosis and CPT/HCPCS codes. This leader ensures adherence to regulatory guidelines and payer requirements and supports optimal reimbursement through quality coding practices.

Requirements

Current permanent US Work Authorization required
Associate or bachelor’s degree in health information management or healthcare administration.
5+ years of experience in professional medical coding with an additional 2+ years in a coding leadership role.
AAPC Certification Required: CPC
Epic experience and proficiency.
Experience with 3M/Solventum Encoder.
Previous experience managing remote coding teams.
Understanding of multiple specialties e.g. E/M, Emergency Medicine, Family practice, Hospitalists, OB, critical care, ancillary, IV infusion, outpatient departments, Urgent Care, Primary Care, Inpatient E/M, Pediatrics, Observation, Ancillary services, and claim edit work queues.
Strong knowledge of HCCs, NCCI edits, and medical necessity concepts.
Current permanent U.S. Work Authorization required.
Strong communication skills and desire to work as part of a team in a partnership role
Advanced excel skills, working knowledge of advanced Tableau and /or other data mining and data visualization tools, report writing and workflow design

Nice To Haves

AHIMA Certification preferred (in addition to the required CPC): RHIT or RHIA
Professional coding auditing experience preferred
Large Health system experience preferred
Matrix management organization
Working with global coding teams
Experience working with data from various sources preferred

Responsibilities

Provide oversight of global professional coding team performance.
Act in the role of professional coding point of contact for multiple clients.
Manage relationships with global professional coding leadership.
Maintain EPIC coding edit work queues, resolving coding edits to ensure accurate and timely claims submission.
Support global professional coding teams through Epic system analytics and reporting.
Provide guidance on CMS and commercial payer regulations, ensuring adherence to current coding and billing standards.
Conduct ongoing compliance monitoring and risk assessments to prevent coding errors and revenue leakage.
Serve as a coding subject matter expert for Revenue Cycle Management (RCM) teams, resolving complex coding and denial-related issues.
Supervise and support professional coding staff including hiring, onboarding, scheduling, and performance management.
Monitor coding productivity, accuracy, and turnaround time for coding completion.
Ensure timely resolution of coding-related edits and billing holds.
Manage multiple work demands simultaneously.
Conduct coding audits and accuracy reviews, ensuring compliance with ICD-10, CPT/HCPCS, and applicable CMS/OIG regulations.
Address coding-related denials and partner with billing and A/R teams to identify root causes.
Stay current with regulatory and coding updates and disseminate guidance to staff.
Ensure coding policies & procedures are current and reflect the most compliant/accepted practices for professional coding.
Ensured compliance of federal, state and HIPAA guidelines.
Work closely with HIM, Revenue Integrity, CDI, Billing, and Clinical departments to ensure clean claim generation.
Support charge description master (CDM) accuracy through collaboration with revenue integrity.
Coordinate with IT on encoder, EHR, and CAC system optimization.
Provide regular coder education on coding updates, documentation changes, and audit findings.
Mentor coding leads or senior coders to support succession planning and career development.
Work closely with physicians, nurses, and other healthcare professionals to ensure timely and accurate documentation that reflects the care provided to patients. Obtain clarification as appropriate.