Manager, Coding and Revenue Integrity

This is a fully remote position, open to applicants in Connecticut, +3 more states.

📋 Description

• Supervise processes to ensure accurate coding compliance, billing integrity, reimbursement, and performance of the revenue cycle.

• Facilitate the onboarding of new coders, which includes participating in interviews, providing training on systems, and evaluating proficiency and accuracy for a period of 30 days.

• Oversee charge capture processes to guarantee precise and timely billing.

• Review billing edits, denials, underpayments, and reimbursement trends.

• Ensure adherence to federal, state, and payer billing regulations.

• Create and sustain standardized workflows for professional billing, coding policies, and training programs.

• Monitor coding volume and coder workload to ensure even distribution and prompt chart coding.

• Develop backup strategies and cross-coverage plans for absences.

• Collaborate with teams in Coding, Billing, Compliance, IT, and Clinical Operations.

• Provide annual updates on coding for staff, providers, and leadership in partnership with the Director of Billing and Coding.

• Coordinate audits and implement corrective actions regarding billing practices.

• Conduct internal audits on documentation, coding, and billing accuracy.

• Ensure compliance with CMS, payer, and regulatory standards.

• Prepare reports and recommendations for leadership consideration.

• Assist with external audits and payer reviews.

• Track metrics and KPIs within the revenue cycle.

• Present findings and strategic recommendations to senior leadership.

• Execute other responsibilities as assigned.

⛳️ Requirements

• A Bachelor's degree is preferred; relevant experience may be taken into account.

• An active coding certification is required (CPC, CCS, CCS-P, COC, or equivalent).

• At least 5 years of progressive experience in professional billing, revenue integrity, coding, or revenue cycle operations.

• A minimum of 3 years in a leadership or supervisory role.

• Advanced knowledge of professional billing workflows, charge capture processes, payer reimbursement methodologies, and denial management.

• Strong comprehension of CPT, HCPCS, ICD-10-CM, and the application of modifiers.

• Capability to analyze complex data sets and implement operational enhancements.

• Excellent written and verbal communication skills, with the ability to engage physicians, operational leaders, and executives.

🏝️ Benefits

• Outstanding growth and advancement opportunities.

• A dynamic work environment.

• Access to a diverse network of practitioners.

• A wide array of tools and programs designed to enhance the employee experience.

• Competitive compensation package.

• Generous paid time off (PTO).

• Health, dental, and vision insurance benefits.

• 401(k) plan.