Coding Manager - SA

Omega Healthcare Management Services•Boca Raton, FL

About The Position

The Coding Manager provides overall management and direction of coding and abstracting activities and leads daily coding operations for inpatient, outpatient, and professional fee services across the Central and West regions. The role supervises, mentors, and evaluates medical coders; manages staffing and performance; and provides leadership and expertise in coding, compliance, reimbursement, and coded-data reporting. The position supports coding accuracy and compliance through audits, validation programs, quality reviews, staff and provider education, policy development, and corrective action. It collaborates with clients, medical staff, other departments, and IT analysts to resolve documentation and reimbursement issues and improve coding systems, tools, performance, and data integrity. The manager also monitors productivity, service-level agreements, turnaround times, accounts receivable and DNFB, budgets, and financial targets, and presents performance and validation metrics to clients and senior leadership. The role requires knowledge of coding and payment methodologies, ICD-10-CM/PCS, ICD-9, CPT, HCPCS, CMS and payer guidelines, and relevant regulatory requirements. It involves use and support of electronic health records, coding and abstracting systems, databases, reporting tools, and company-approved collaboration technology. The manager must follow company policies, HIPAA requirements, and AHIMA’s Standards of Ethical Coding.

Requirements

Bachelor’s degree in Health Information Management, Nursing, or a related field.
Minimum of 5 years of progressive coding experience, including inpatient facility coding.
Demonstrated expertise in outpatient and professional fee coding.
Strong supervisory and team-leadership skills, with a track record of staff development.
In-depth knowledge of CMS, ICD-10-CM/PCS, CPT, HCPCS, and payer coding guidelines.
Proficiency with Epic EHR and 3M/Solventum coding software.
Experience conducting internal audits and managing responses to external audits.
Ability to work across coding work types and specialties.
Ability to prioritize and manage multiple tasks in a fast-paced, changing environment.
Ability to self-motivate, set goals, and meet deadlines.
Leadership, mentoring, interpersonal, presentation, verbal, and written communication skills.
Ability to build credible, trusting relationships with business partners and maintain professional working relationships at all organizational levels.
Strong analytical, critical-thinking, and problem-solving skills, including making decisions at client sites without ongoing upper-management supervision.
Skill operating a personal computer and using a variety of software applications.
Ability to analyze data, generate reports, and drive process improvements.
Commitment to high accuracy and compliance standards.

Nice To Haves

RHIT, RHIA, or CCS certification.

Responsibilities

Manage and direct coding and abstracting activities, including daily inpatient, outpatient, and professional fee coding operations across the Central and West regions.
Oversee coding staff duties, supervise and mentor coders, evaluate performance, and support employee selection, promotion, discipline, or discharge actions as appropriate.
Manage staffing resources to accommodate patient volume, turnaround-time expectations, client agreements, and financial targets.
Respond to coding and abstracting data and report requests from clients, physicians, and internal customers.
Use database queries and reports to conduct audits and other validation activities.
Develop and oversee internal and external coding validation programs in conjunction with client programs.
Identify cases, monitor data-collection timeliness, aggregate and analyze data, and track trends.
Provide individual and summary feedback to coding staff for performance improvement and compliance.
Report validation findings to clients monthly and identify opportunities for clinical documentation improvement and coder education.
Develop and deliver ongoing coding education and in-service programs for coding staff and clinical providers.
Work with medical staff and other departments to resolve coding, documentation, and reimbursement issues.
Maintain and update coding and abstracting policies, procedures, and internal coding guidelines.
Ensure month-end coding activity is completed for abstracting within client timelines.
Prepare monthly management reports on productivity and quality and present coding performance metrics to senior leadership.
Lead root-cause analysis for denials and implement corrective action plans.
Maintain current knowledge of payment methodologies, grouping classifications, coding systems, regulations, and industry best practices.
Ensure compliance with OIG, CMS, state Medicaid, third-party payer, RAC, and other state and federal auditing contractor requirements.
Collaborate with IT analysts and clients to configure and optimize Epic and 3M/Solventum coding tools and improve system performance, efficiency, and data integrity.
Assist with system analysis, implementation, testing, database management, maintenance, accuracy, regulatory compliance, troubleshooting, and security for coding and abstracting systems, interfaces, databases, and reporting tools.
Monitor the coding team’s adherence to AHIMA’s Standards of Ethical Coding and report concerns.
Assist with preparation and monitoring of operating budgets.
Complete weekly Omega Solutions metrics reports and work with the Omega Solutions team to vet candidates for appropriate client assignments.
Meet client engagement service-level agreements, budgetary goals, and specified margins.
Manage accounts receivable and DNFB.
Coordinate coding staff meetings and keep staff informed of health information management and regulatory changes, developments, and events.
Participate in virtual meetings, training, coaching, audits, and other work-related interactions using company-approved collaboration technology, including audio and video when required.
Perform duties in compliance with company policies and procedures, including HIPAA and compliance policies.