Medical Coding Manager

The Cardiovascular Care Group•Springfield, NJ

About The Position

The Medical Coding Manager leads the professional coding team for a high-volume, multispecialty vascular surgery practice. The role combines hands-on technical oversight of complex vascular surgery coding with responsibility for team performance, coding quality, operational efficiency, compliance, and revenue integrity across hospital-based procedures, ambulatory surgery centers (ASCs), office-based laboratories (OBLs), office visits, imaging, and other vascular services. The manager oversees and develops staff, establishes performance standards, manages workloads and work queues, resolves complex coding issues, conducts prospective and retrospective audits, and improves provider documentation. The position establishes proactive processes—including risk-based pre-billing reviews, targeted audits, provider education, and analysis of missed charges, undercoding, documentation deficiencies, and recurring errors—to identify and address issues before claims are submitted. The manager works with physicians, coding staff, billing and revenue cycle personnel, authorization and clinical operations, compliance, and executive leadership to implement measurable improvements while maintaining coding integrity and applicable compliance requirements. The role also leads process-improvement projects, develops performance reporting and dashboards, evaluates coding technology and automation, and reports findings and recommendations to leadership. Success is measured by results in team productivity and performance, coding quality and compliance, charge capture and revenue integrity, provider education, project execution, and management reporting.

Requirements

At least 5–8 years of professional medical coding experience, including substantial hands-on vascular surgery coding experience.
Demonstrated experience managing, supervising, auditing, or leading a professional coding team.
Strong technical knowledge of complex open and endovascular vascular surgery coding.
Advanced knowledge of CPT, HCPCS, ICD-10-CM, modifiers, NCCI edits, global surgery rules, CMS requirements, and commercial payer policies.
Ability to interpret complex operative reports and independently resolve difficult coding scenarios.
Experience developing or conducting coding audits, analyzing errors, and implementing corrective action.
Ability to manage staff performance, establish expectations, coach employees, and address performance deficiencies.
Strong analytical and problem-solving skills, including investigating issues, determining root causes, and implementing sustainable solutions.
Experience leading projects or process improvements with measurable outcomes.
Strong organizational skills and ability to manage multiple priorities and deadlines.
Proficiency in Microsoft Excel and experience using EMR/EHR, encoder, billing, practice management, or reporting systems.
Excellent written and verbal communication skills, including the ability to present technical findings to physicians and noncoding stakeholders.

Nice To Haves

CPC, CCS-P, CIRCC, COC, or equivalent professional coding certification; CIRCC and/or CCS credentials are strongly preferred.
Experience with coding compliance audits, provider education, and documentation improvement initiatives.
Experience implementing prospective claim reviews or other coding controls to improve charge capture and prevent claim errors.
Experience with vascular surgery revenue cycle operations and commercial payer reimbursement requirements.
Experience with Aprima, Epic, or comparable EMR/PM systems.
Experience with reporting automation, AI-assisted coding, or coding workflow technology.
Bachelor's degree in healthcare administration, health information management, business, or a related field.

Responsibilities

Lead and manage the day-to-day operations of the professional coding team, including staff performance, productivity, accuracy, turnaround time, and quality.
Establish departmental goals, performance expectations, accountability standards, standardized workflows, written procedures, escalation protocols, and cross-training plans.
Monitor coding production, work queues, backlogs, aging, quality metrics, and turnaround times; assign workloads and address performance deficiencies through coaching, training, improvement plans, and corrective action as appropriate.
Provide technical oversight of complex professional vascular surgery coding and serve as an escalation resource for difficult cases, unusual operative reports, and conflicting coding interpretations.
Ensure appropriate CPT, HCPCS, ICD-10-CM, and modifier assignment in accordance with applicable AMA, CMS, NCCI, Medicare, and commercial payer requirements.
Investigate coding discrepancies, identify root causes, resolve recurring coding questions consistently, and identify missed charges, undercoding, overcoding, modifier errors, bundling errors, and documentation deficiencies.
Establish appropriate provider query processes when documentation is incomplete, ambiguous, or insufficient to support accurate coding.
Develop and manage a structured prospective and retrospective coding audit program, including risk-based audit priorities, tracking, root-cause analysis, corrective actions, and documentation of findings.
Coordinate with providers and leadership to review audit results, clarify documentation requirements, deliver corrective education, and escalate material compliance concerns.
Establish risk-based pre-billing reviews for selected claims and encounters; identify and correct coding and documentation issues before claims are released for billing.
Work with billing and revenue cycle leadership to address claim issues, coding-related denials, underpayments, reimbursement discrepancies, and recurring billing corrections before and after submission.
Analyze missed-charge findings, coding edits, preventable denials, corrected claims, and revenue leakage; recommend compliant workflow changes to improve charge capture and reduce rework.
Develop and deliver provider education based on audits, documentation deficiencies, coding trends, and revenue opportunities; maintain education records and conduct follow-up reviews.
Work with physicians and clinical leadership to improve operative reports, procedure notes, E&M documentation, and other records supporting professional claims.
Lead process-improvement projects from problem identification through implementation, monitoring, and evaluation; define project plans, responsibilities, timelines, and success measures.
Coordinate changes with physicians, billing, revenue cycle, authorization, clinical operations, compliance, and other stakeholders; monitor progress and hold responsible parties accountable for deliverables.
Develop and maintain coding performance reports and dashboards covering productivity, accuracy, turnaround time, audit trends, documentation deficiencies, pre-billing findings, missed charges, denials, staff needs, and project outcomes.
Use Microsoft Excel, EMR/PM reporting tools, and available analytics resources to investigate trends, identify root causes, and present actionable recommendations to leadership.
Evaluate coding workflow improvements through system enhancements, automation, reporting, and AI-assisted coding tools; participate in testing and implementation and establish human review and quality controls for automated outputs.
Support consistent policies and workflows across hospital, ASC, OBL, and office-based services, and communicate operational risks, resource constraints, and improvement opportunities to leadership.

Benefits

Medical coverage; the group pays 100% of Employee Only coverage with the Cigna Bronze plan.
Three dental plans through Delta Dental and Cigna.
Two vision plans through Delta and VSP.
Health Savings Account and Flexible Spending Accounts for healthcare, dependent care, transit, and parking through Upswing.
$25,000 group-paid life insurance, with optional additional voluntary coverage.
Short-term and long-term disability through New York Life, with optional additional voluntary coverage.
Optional accident, critical illness, and hospital indemnity benefits through New York Life.
Paid time off.
Holiday pay.
One day of full-pay jury duty leave.
Employee Assistance Programs through RWJBH and Cigna.
401(k) employer contribution of 3% upon eligibility.
Working Advantage and Life Mart employee discounts.
Employee engagement activities, including a holiday party, appreciation days, ice cream socials, fundraisers, contests, and prizes.