Manager Compliance Coding

Texas Health Resources • VA

76d

About The Position

The Coding Compliance Manager oversees and manages auditing and monitoring activities related to billing and coding compliance. This role is responsible for developing policies, procedures, and risk-based educational materials to ensure adherence to federal and state regulations, as well as THR policies. Key responsibilities include analyzing audit data to identify areas of concern, collaborating with auditees, providers, and leadership to guide rebuttals, and establishing management correction plans when necessary. Additionally, the Compliance Auditor Manager effectively communicates audit findings through reports, presentations, and educational materials tailored for executive leadership and relevant stakeholders. Serving as a trusted resource, this position provides guidance to providers, HIMS, the Central Billing Office, and other departments regarding coding compliance, documentation standards, and applicable federal, state, and THR/THPG regulations.

Requirements

• Bachelor's Degree Required.
• 6 Years Experience in conducting compliance coding and billing audits including supervising and managing coding/auditing in a medium to large healthcare system.
• Supervisory and/or leadership experience required.
• Licenses and Certifications: RHIT, RHIA, CCS, or CPC required upon hire.

Nice To Haves

• Strong understanding of leadership principles and best practices in team management.
• Expertise in planning, scheduling, and overseeing projects.
• Exceptional oral and written communication skills.
• Ability to analyze data and recommend solutions for compliance challenges.
• Extensive knowledge of MS DRG, APC, ICD-10-CM/PCS, CPT, HCPCS coding.
• Proficiency in Microsoft Office products (Excel, Word, PowerPoint).
• Demonstrated ability to work autonomously and meet deadlines.
• Strong listening skills and ability to train others.

Responsibilities

• Oversee and manage auditing and monitoring activities related to billing and coding compliance.
• Develop policies, procedures, and risk-based educational materials for compliance.
• Analyze audit data to identify areas of concern.
• Collaborate with auditees, providers, and leadership to guide rebuttals.
• Establish management correction plans when necessary.
• Communicate audit findings through reports and presentations.
• Provide guidance to providers and departments on coding compliance and documentation standards.
• Identify compliance risks and recommend corrective actions.
• Support the Director in developing the annual work plan for compliance.
• Inform and educate staff on regulatory requirements and payer guidelines.
• Conduct additional reviews for departments handling denials.
• Research coding and compliance inquiries from various departments.
• Lead the coding audit team, including training and performance evaluation.
• Monitor and manage vendor performance for compliance.
• Conduct internal audit testing to ensure adherence to regulatory requirements.
• Assist the audit team with coding assessments.
• Perform second-level reviews of billing performance.
• Prepare detailed audit reports and present findings to senior leadership.
• Conduct follow-up audits when significant compliance risks are identified.

Benefits

• Family-friendly hours.
• Top-notch benefits.
• Career growth and professional development opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees