SUMMARY
Provides operational oversight for professional coding functions.
ESSENTIAL DUTIES
The duties and responsibilities described below represent the essential functions of the job. Other duties or responsibilities may be assigned at the discretion of the immediate supervisor and/or leadership within the individual’s hierarchy.
- Provide leadership and supervision to multi-specialty coding team, ensuring accurate and timely coding of encounters by ICD-10, CPT, and HCPCS standards and CMS, HRSA, and payer-specific guidelines.
- Ensure effective collaboration between providers, coders, and billers to support compliant documentation and optimal coding outcomes.
- Collaborate with clinical providers to enhance documentation quality and accuracy, supporting compliant billing, appropriate risk stratification, and accurate Uniform Data System (UDS) reporting.
- Conduct routine internal coding audits and chart reviews to monitor accuracy, identify trends, and implement corrective actions supporting compliance and data integrity.
- Maintain current knowledge of federal, state, and payer coding regulations and update internal protocols and workflows to ensure compliance and operational consistency.
- Design and deliver ongoing training for providers and coding staff on documentation improvement, regulatory changes, and best practices for accurate and compliant coding.
- Monitor coding productivity, accuracy, and quality metrics; develop and implement performance improvement plans to meet departmental and organizational benchmarks.
- Assist in the development and implementation of policies, procedures, and system enhancements to ensure optimal reimbursement with regulatory requirements across Revenue Cycle units.
- Partner in developing strategy to address high-risk coding practices, recommendations for corrective action plans or process improvements and creates policies, procedures, and internal controls which reinforce the highest level of standard coding quality goals and outcomes.
- Identify and address change management issues related to the evolution of the Revenue Cycle environment.
- Provide leadership for process improvement and redesign to improve customer satisfaction, reduce costs, and/or meet departmental and institutional goals and objectives.
- Track and report coder productivity, collecting relevant data.
- Monitor key performance indicators/metrics and enact action plans to encourage exceptional results.
SUPERVISORY RESPONSIBILITIES
Supervises: Coding Specialist, Sr. Coding Specialist
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The qualifications listed below are representative of the knowledge, skills, and/or abilities required for this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Required Education
Verifiable completion of the following degree in a major relevant to the role is required:
Bachelor's degree in Health Information Management or related field.
Five (5) years of coding experience will be considered in lieu of degree.
Preferred Education
- Master's Degree in Health Information Management or related field.
Required Experience
- Five (5) years of experience in professional coding.
- Two (2) years of management experience required.
- Three (3) years of Epic and/or Athena experience required.
Licenses, Certifications and/or Registrations
Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification.