Manager, Professional Coding Quality & Education, Health Information Management, Full Time
About The Position
The Manager, Professional Coding Quality & Education is a key leader within Health Information Management (HIM) and the Medical Group organization. This role is responsible for leading coding education and quality operations across the physician enterprise and partners closely with physician leadership, operational leaders, Compliance, Finance, Revenue Cycle, Clinical Departments, Information Technology, Clinical Documentation Integrity (CDI), and outsourced coding vendors to ensure accurate, timely, and compliant coding practices that support quality care, regulatory compliance, and optimal reimbursement. The Manager develops and implements coding education, oversees coding quality and audit programs, provides coding guidance to providers and operational leaders while promoting coding excellence through provider education, coding quality improvement, audit readiness, performance analytics, and technology optimization. This leader drives the adoption of innovative coding technologies, including computer-assisted coding (CAC), AI-enabled coding solutions, and workflow automation to improve coding performance, documentation integrity, ICD-10 specificity, and reimbursement accuracy.
Requirements
- Bachelor’s degree required.
- Certified Professional Coder (CPC), or equivalent professional coding certification required.
- Five or more years of progressive professional coding leadership experience within an integrated health system, academic medical center, or large physician enterprise.
- Demonstrated experience leading professional coding quality, compliance and education initiatives.
- Experience partnering with physician leadership, clinical departments, revenue cycle, compliance, finance, and information technology.
- Expert knowledge of professional coding guidelines, including: ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, Medicare, Medicaid, and commercial payer reimbursement methodologies.
- Strong knowledge of federal and state regulations governing coding, billing, documentation, and reimbursement.
- Strong understanding of physician documentation requirements and documentation integrity principles.
- Ability to collaborate effectively with physicians, executive leadership, operational departments, clinical operations, finance, compliance, revenue cycle, clinical documentation integrity, and information technology.
- Strong analytical skills with experience utilizing coding productivity, quality, reimbursement, denial, and audit data to drive operational improvements.
- Demonstrated leadership in change management, process improvement, and technology implementation.
Nice To Haves
- Degree in Health Information Management (HIM) preferred.
- RHIT or RHIA certification preferred.
- Experience implementing coding technology, encoder software, computer-assisted coding, AI-assisted coding, and workflow optimization tools preferred.
- Strong understanding of ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, HCCs, and value-based reimbursement methodologies.
Responsibilities
- Develops and implements coding education.
- Oversees coding quality and audit programs.
- Provides coding guidance to providers and operational leaders.
- Promotes coding excellence through provider education, coding quality improvement, audit readiness, performance analytics, and technology optimization.
- Drives the adoption of innovative coding technologies, including computer-assisted coding (CAC), AI-enabled coding solutions, and workflow automation to improve coding performance, documentation integrity, ICD-10 specificity, and reimbursement accuracy.
- Manages outsourced coding vendors and vendor performance.
- Leads and develops coding quality initiatives, provider education programs, audit response, and regulatory compliance activities.
Benefits
- Medical/Prescription, Dental & Vision Discount Program (Full Time/Part Time Employees)
- Group Term Life Insurance and AD&D(Full Time Employees)
- Flexible Spending Accounts and Commuter Benefit Plans
- Supplemental Voluntary Benefits ( e.g. Short-term and Long-term Disability, Whole Life Insurance, Legal Support, etc.)
- 6 Paid Holidays, Paid Time Off (varies), Wellness Time Off, Extended Illness
- Retirement Plan
- Tuition Assistance
- Employee Assistance Program (EAP)
- Valley Health LifeStyles Fitness Center Membership Discount
- Day Care Discounts for Various Daycare Facilities
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What This Job Offers
Job Type
Full-time
Career Level
Manager
