DescriptionPosition SummaryThe Coding Manager, Compliance is responsible for leading provider-focused auditing, education, and compliance efforts to ensure accurate coding practices and adherence to regulatory and payer requirements. This role partners closely with providers, Operations and Revenue Cycle Management (RCM) teams to drive sustainable improvements in coding accuracy, mitigate risk, and promote a culture of compliance across the organization.
Key Responsibilities1. Provider Audit Program
- Lead and manage provider chart audit activities to support the organizational goal of auditing all providers annually.
- Ensure audits are conducted accurately, consistently, and in alignment with regulatory and payer requirements.
- Identify trends, risks, and opportunities for improvement through audit findings.
2. Provider Education & Training
- Deliver targeted education to providers based on audit results, addressing identified gaps and opportunities.
- Develop and conduct onboarding education for new providers on coding, documentation standards, and compliance expectations.
- Design and implement ongoing education programs focused on coding updates, regulatory changes, and "hot topics."
- Define training structure, format (e.g., live sessions, materials, digital modules), and cadence.
- Tailor content to provider specialties and organizational priorities.
3. Payor Audit Management
- Track and manage all payor audit activity, including requests, responses, and outcomes.
- Coordinate timely and accurate responses to payor audits.
- Translate audit findings into actionable provider education and process improvements.
4. Cross-Functional Collaboration
- Partner with RCM leadership and operational teams to identify and implement changes that improve coding accuracy and reduce compliance risk.
- Balance compliance requirements with operational realities to support practical, sustainable solutions.
- Contribute to initiatives that drive long-term improvements in coding performance and revenue integrity.
Other duties as assigned.
What We Offer- Comprehensive Health Benefits (Medical, Dental, and Vision)
- Health Savings Account (HSA)
- Flexible Spending Account (FSA)
- Short & Long Term Disability
- Holidays & Paid Time Off (PTO)
- Employee Assistance Program (EAP)
- Retirement Contribution Program - 401(K) Match
RequirementsQualifications- Bachelor's degree in health information management, Health Administration, or a related field (Master's degree preferred). Equivalent experience may be considered.
- 8+ years of experience in coding within a healthcare setting.
- Experience in a multi-location healthcare environment, preferably within ENT or Allergy specialties, is a plus.
- Proficiency in coding systems and guidelines (CPT, ICD-10, and HCPCS) and a strong understanding of coding compliance and documentation requirements.
- Experience with coding and billing software, electronic medical records (EMR), and reporting tools.
- Active certification in one or more of the following:
- CPC (Certified Professional Coder)
- CCS-P (Certified Coding Specialist-Physician Based)
- RHIA (Registered Health Information Administrator)
- RHIT (Registered Health Information Technician)
- Strong analytical and problem-solving abilities, with attention to detail and process optimization.
- Effective communication and interpersonal skills, with the ability to collaborate with clinical and operational leaders.
