Manager, Coding, Revenue Integrity and Provider Engagement

Illinois Bone and Joint Institute LLC•Park Ridge, IL

1d•$104,000 - $142,000•Onsite

About The Position

The Manager, Coding, Revenue Integrity & Provider Engagement provides leadership and oversight for professional coding, coding-related revenue integrity, provider education, and physician revenue cycle support across Illinois Bone & Joint Institute (IBJI). This role establishes consistent coding standards, oversees outsourced coding services, monitors coding quality and performance, identifies revenue integrity opportunities, and ensures coding practices support accurate and compliant reimbursement. The Manager serves as a key connection between Revenue Cycle and IBJI physicians and advanced practice providers, translating coding, documentation, reimbursement, and revenue cycle trends into clear, actionable information. The position moves beyond individual account resolution to identify patterns, strengthen processes, develop education, and work collaboratively with providers, operational leaders, Revenue Cycle teams, Compliance, Information Technology, and external coding partners.

Requirements

Bachelor's degree in healthcare administration, health information management, business, or a related field; equivalent relevant experience may be considered
Professional coding certification such as CPC, CCS-P, CCS, or equivalent required
Significant experience in professional coding, revenue cycle, revenue integrity, coding compliance, or a related healthcare field, including leadership responsibility
Experience leading coding operations, coding quality, provider education, or revenue integrity functions; orthopedic/musculoskeletal coding, outsourced vendor management, Epic Resolute Professional Billing, and multispecialty physician enterprise experience strongly preferred
Advanced knowledge of CPT, HCPCS, ICD-10-CM, modifiers, NCCI edits, Medicare coding requirements, professional fee reimbursement, coding audits, denial analysis, and revenue integrity principles; proficiency with Epic Resolute Professional Billing and reporting tools preferred
Strong leadership, analytical, communication, organization, and change management skills with the ability to identify trends and move from individual account issues to broader operational solutions
Demonstrated ability to build credibility and communicate effectively with physicians, advanced practice providers, operational leaders, executive leadership, Compliance, IT/Epic teams, and external partners

Nice To Haves

orthopedic/musculoskeletal coding
outsourced vendor management
Epic Resolute Professional Billing
multispecialty physician enterprise experience

Responsibilities

Provide overall leadership for professional coding operations, coding quality, coding standards, and coding related workflow across IBJI
Establish and maintain standardized coding practices consistent with CPT, HCPCS, ICD-10-CM, CMS, NCCI, payer requirements, and applicable regulatory guidance
Provide oversight of outsourced coding services, including service levels, turnaround times, quality, productivity, escalation processes, and contractual performance
Partner with coding supervisors and external coding vendors to maintain appropriate coding workflow and timely charge submission
Oversee coding work queues, coding edits, provider queries, charge corrections, and other coding-related exception processes
Analyze coding related denials to identify trends, root causes, provider education opportunities, payer issues, system configuration concerns, and process gaps
Partner with other Revenue Cycle leaders to ensure coding related denials are addressed consistently and appropriately
Identify opportunities for appropriate revenue capture while maintaining compliant coding practices
Evaluate trends involving modifiers, bundling edits, medical necessity, procedure coding, documentation, charge capture, and other areas affecting reimbursement
Establish processes for reviewing potential under coding, over coding, missed charges, inappropriate edits, and other revenue integrity concerns
Work with Epic and Revenue Cycle teams to identify system or workflow changes that can prevent recurring coding and charge capture issues
Establish a structured coding quality program that includes routine audits, targeted reviews, trend analysis, and measurable quality expectations
Partner with Compliance on coding concerns, regulatory interpretation, audit findings, and corrective action when appropriate
Develop and maintain coding policies, procedures, reference materials, and standardized workflows
Develop a structured provider education program focused on documentation, coding, reimbursement, medical necessity, and revenue cycle performance
Develop provider tip sheets, educational materials, presentations, and specialty specific resources, and provide individual or group education based on identified trends and needs
Coordinate coding and documentation education for new providers as part of the onboarding process and measure the effectiveness of provider education
Serve as a primary Revenue Cycle resource for physicians and practice leadership regarding coding, documentation, reimbursement, and revenue cycle concerns
Coordinate investigation and resolution of provider raised coding/coding denial concerns and identify when an individual concern represents a broader process, payer, or system issue
Provide providers and leadership with meaningful performance information, including coding trends, denial patterns, documentation opportunities, and revenue cycle results
Provide direct leadership, coaching, and development for assigned coding supervisors and other team members; establish clear expectations for quality, productivity, accountability, and issue escalation
Lead and participate in cross functional process improvement efforts designed to reduce manual work, eliminate duplication, prevent denials, and improve revenue cycle performance
Maintain a clean and safe work environment
Other duties as assigned