Manager, Coding & Revenue

JOB DESCRIPTION The position description is a guide to the critical duties and essential functions of the job, not an all-inclusive list of responsibilities, qualifications, physical demands and work environment conditions. Position descriptions are reviewed and revised to meet the changing needs of the organization.

TITLE: Manager, Coding & Revenue

JOB OVERVIEW: The Manager, Coding & Revenue provides strategic leadership and oversight for the professional coding, physician auditing & education, coding and charge capture, and provider enrollment functions. The role is responsible for ensuring accurate and compliant professional charge capture and coding, while directing reconciliation and quality assurance processes to strengthen revenue integrity and support appropriate reimbursement.

DEPARTMENT: Patient Finanical Services

WORK HOURS: Monday - Friday, typically 8:00 AM - 4:30 PM. Flexibility may be required to meet department and organization needs. RESPORTS TO: Director, Health Information Management and Revenue Integrity

PREREQUISITES:

Bachelor''s degree in a related field or 4 or more years of equivalent work experience and education, required.

Certified Professional Coder (CPC) through AAPC or Certified Coding Specialist-Physician based (CCS-P) through AHIMA required;Certified Professional Medical Auditor (CPMA) preferred.

Minimum five (5) years of experience in physician auditing and education, including at least three (3) years of developing and delivering training materials to staff and provider groups.

Minimum four (4) years of progressively responsible supervisory experience or management experience in a multispecialty group required. Experience managing in a union environment and hybrid (remote/on-site) teams preferred.

Proficient in various computer applications, including Microsoft Office, Excel, Word, PowerPoint, Visio, and Outlook

QUALIFICATIONS:

Knowledge of Revenue Integrity principles, including coding accuracy, clinical documentation integrity, charge capture, price transparency, and payer/provider audits.

Knowledge of Federal, State, and commercial payer requirements, including CPT/HCPCS and ICD-10-CM coding for professional services, along with comprehensive understanding of applicable healthcare regulations such as HIPAA, billing requirements, and regulatory compliance related to professional coding and documentation.

Demonstrates excellent oral and written communication skills, with the ability to build and maintain collaborative working relationships and exhibit strong teamwork as both an effective leader and a collaborative team member across all levels of leadership, providers, and staff

Proficient in interpreting physician documentation to identify and extract billable services in accordance with coding guidelines.

Proven ability to evaluate processes, identify and recommend improvements, and developand implement operational policies and procedures.

Demonstrates the ability to apply root-cause analysis to identify process improvement opportunities and implement effective changes.

Experience managing revenue capture in complex billing environment

Experience in development and management of compliance/audit programs.

Strong leadership skills with experience leading, mentoring, and managing staff across multiple areas of responsibility.

Demonstrates a commitment to excellent customer service, skilled in conflict resolution, exercising sound judgement, and maintaining professionalism under pressure.

Skilled at managing priorities, organizing work efficiently, producing accurate results, following through on tasks, and meeting deadlines.

UNIQUE PHYSICAL/MENTAL DEMANDS, ENVIRONMENT AND WORKING CONDITIONS:

Must possess ability to work independently, with minimal direction, and take initiative in problem solving.

Must be able to interact professionally and effectively with a wide variety of people, including operations staff, providers, the general pu