Job description
Department: Medical Coding
Designation: Manager - Medical Coding
Work Environment: Work from Office
Specialty : All the specialties (ED, E/M, Surgery, Ambulatory Services, Anesthesia, Radiology, IPDRG, Inpatient Coding, Outpatient Coding, Observation, Diagnostic Coding, Denials
The Coding Manager oversees daily coding operations to ensure accurate, compliant and timely assignment of diagnosis and procedure codes across inpatient, outpatient and/or professional services. This role provides leadership to coding staff, drives quality initiatives, ensures regulatory compliance and collaborates with clinical and revenue cycle teams.
Leadership and Time Management
- Supervise, mentor, and support coding staff
- Assign workloads and monitor productivity, accuracy, and turnaround times
- Provide onboarding, education, and performance feedback
- Promote a culture of accountability and continuous improvement
- Support software development team for coding related initiatives
Coding Quality and Compliance
- Ensure adherence to coding guidelines and regulations
- Oversee audits and QA programs
- Track trends and implement education initiatives
- Maintain compliance with CMS and payer requirements
- Stay current on regulatory and industry standards
- Support internal and external audit responses
- Partner with leadership and operational teams to improve performance
- Assist with audits and appeals
- Assist with audits and appeal
Operation and Oversite
- Monitor workflows and staffing needs
- Develop coding policies and procedures
- Support EHR and system upgrades
- Collaborate with HIM, CDI, and billing teams
Audit and Quality Assurance
- Perform routine and focused audits related to coding, documentation, billing, and compliance
- Analyze audit findings to identify trends, risks, and improvement opportunities
- Prepare clear audit reports with actionable recommendations
- Track corrective action plans and conduct re-audits
Education and Training
- Develop targeted education based on audit results and regulatory updates
- Deliver training sessions to providers, coders, and operational staff
- Create educational materials including presentations, tip sheets, and job aids
- Evaluate training effectiveness through follow-up audits
Certifications
- Active coding credential required (CCS, CPC, RHIA, RHIT, CPMA, etc.)
- Overall, 12-15 years of experience in coding.
- DRG or APR-DRG experience preferred
- Professional Fee auditing experience preferred
- Leadership experience is mandatory
Key responsibilities
- Strong analytical and critical thinking skills
- Strong understanding of healthcare billing, denial management and reimbursement processes
- Excellent written and verbal communication
- Ability to manage special projects and assessments
- Organization and presentation skills to facilitate client meetings
- Ability to translate findings into effective education
- Organized and detail-oriented
- Collaborative and professional coaching approach
- Familiarity with coding software and electronic health records
- Ability to work independently and as part of the team
- Experience with DRG/APR-DRG
- Experience in E&M and Outpatient coding.
- Hospital or CAH experience
- Audit and appeals experience
- Coding denials experience is mandatory.
- Familiarity with clinical documentation improvement
- Familiarity with compliance or revenue integrity audits
