About the RoleThe Coding Manager owns overall leadership, performance, and strategic direction of the professional coding function supporting a high-volume, multi-specialty surgical and procedural environment spanning neurosurgery, orthopedic spine, neurology, physiatry, and pain management. This role is accountable for coding quality, compliance, productivity, and staffing outcomes across the coding team, and works closely with the senior coding staff who manage day-to-day operations and serve as front-line subject matter experts. Given the clinical complexity and coding risk inherent in these specialties - multi-level spinal procedures, neurosurgical and pain interventional coding, E/M coding across neurology and physiatry, and tightly scrutinized payer authorization requirements - this role requires deep, demonstrated specialty coding expertise, not generalist coding management experience. The Coding Manager translates RCM leadership priorities into coding department strategy - staffing models, specialty-specific training programs, quality benchmarks, and SOP governance - and is the primary owner of coding department performance reporting to RCM leadership.
This is a management role focused on team leadership, departmental strategy, and cross-functional accountability rather than day-to-day case-level coding work.
Key Responsibilities:- Own overall performance, quality, and compliance outcomes for the coding department across neurosurgery, spine, orthopedics, neurology, physiatry, and pain management coding teams
- Manage and develop the Coding Lead and coding staff, including performance reviews, coaching plans, and disciplinary action as needed
- Serve as the department's senior specialty coding authority - providing expert guidance on complex multi-level spinal procedures, neurosurgical and interventional pain coding, and specialty-specific E/M and modifier application
- Lead staffing strategy for the coding department - headcount planning, hiring for specialty-specific coding expertise, onboarding structure, and workload distribution across specialties and entities
- Own coding department budget and resource planning in partnership with the Head of RCM
- Set and govern specialty-specific coding SOPs, quality audit standards, and escalation frameworks across all coding work queues
- Serve as the executive-level escalation point for high-complexity compliance issues, including authorization mismatches on surgical level-of-service discrepancies, payer policy conflicts, and research billing scenarios
- Partner with Process Improvement, Billing/AR, and Clinical Operations leadership to resolve systemic coding and documentation gaps, particularly around surgical order specificity, and operative note clarity
- Monitor denial trends tied to coding root causes - including specialty-specific denial patterns (e.g., RFA level mismatches, spinal fusion bundling, pain procedure frequency edits) - and own the action plan with billing/AR and clinical leadership
- Ensure ongoing regulatory compliance (CPT, ICD-10, HCPCS, payer-specific guidelines, Medicare Advantage policy) across all supported specialties through targeted training and audit programs
- Own coding department reporting and present performance metrics, specialty-specific trends, and improvement plans to RCM and executive leadership
- Represent the coding function in cross-entity and MSO-wide initiatives as the department scales to additional specialty practices
Requirements
- Active coding certification (CPC, CCS, or equivalent) through AAPC or AHIMA
- 5+ years of medical coding experience with direct surgical / procedural coding exposure
- Mastery of CPT, ICD-10-CM, HCPCS, and official coding guidelines
- Minimum 3-4 years in a management or department leadership capacity overseeing coding staff in a surgical/procedural specialty environment
- Demonstrated expert-level knowledge of CPT, ICD-10-CM, HCPCS, and NCCI/payer edit logic as applied to neurosurgical, spinal, and interventional pain procedures
- Experience with Epic practice management and coding workflows
- Demonstrated experience managing staffing, performance, and budget for a specialty coding team
Preferred Qualifications:- Specialty coding certification or credentialing specific to neurosurgery, orthopedics, or pain management (e.g., CPC-S, COSC, CASCC)
- Direct experience coding and managing coders for multi-level spinal fusions, RFA/neuroablation procedures, and other complex neurosurgical or interventional pain cases
- Experience managing prior-authorization and RFA-related billing compliance programs
- Track record of building or scaling specialty-specific coding SOPs, training programs, or quality audit frameworks
- Experience operating within a multi-entity or MSO coding structure
- Coding instructor or auditor credentials
Core Competencies:- Deep specialty coding expertise (neurosurgery, spine, orthopedics, neurology, physiatry, pain management)
- Departmental leadership and staff development
- Strategic workforce and budget planning
- Regulatory compliance ownership
- Cross-functional executive collaboration (billing, AR, clinical operations, finance)
- Performance management and accountability
- Data-driven decision making and executive reporting
Tools & Systems Exposure:- Epic (coding work queues, charge review, claim edits)
- 3M, EncoderPro, or similar coding/encoder software
- Payer portals and prior-authorization systems
- Workforce/budget planning tools
