Position Summary

The Manager, Professional Coding Quality & Education is a key leader within Health Information Management (HIM) and the Medical Group organization. This role is responsible for leading coding education and quality operations across the physician enterprise and partners closely with physician leadership, operational leaders, Compliance, Finance, Revenue Cycle, Clinical Departments, Information Technology, Clinical Documentation Integrity (CDI), and outsourced coding vendors to ensure accurate, timely, and compliant coding practices that support quality care, regulatory compliance, and optimal reimbursement.

The Manager develops and implements coding education, oversees coding quality and audit programs, provides coding guidance to providers and operational leaders while promoting coding excellence through provider education, coding quality improvement, audit readiness, performance analytics, and technology optimization. This leader drives the adoption of innovative coding technologies, including computer-assisted coding (CAC), AI-enabled coding solutions, and workflow automation to improve coding performance, documentation integrity, ICD-10 specificity, and reimbursement accuracy.

Education

Bachelor's degree required. Certified Professional Coder (CPC), or equivalent professional coding certification required. Degree in Health Information Management (HIM) preferred with a RHIT or RHIA certification preferred.

Experience

• Five or more years of progressive professional coding leadership experience within an integrated health system, academic medical center, or large physician enterprise.
• Demonstrated experience leading professional coding quality, compliance and education initiatives
• Experience partnering with physician leadership, clinical departments, revenue cycle, compliance, finance, and information technology.
• Experience managing outsourced coding vendors and vendor performance.
• Experience leading and developing coding quality initiatives, provider education programs, audit response, and regulatory compliance activities.
• Experience implementing coding technology, encoder software, computer-assisted coding, AI-assisted coding, and workflow optimization tools preferred.
• Strong understanding of ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, HCCs, and value-based reimbursement methodologies.

Skills

• Expert knowledge of professional coding guidelines, including: ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, Medicare, Medicaid, and commercial payer reimbursement methodologies.
• Strong knowledge of federal and state regulations governing coding, billing, documentation, and reimbursement.
• Strong understanding of physician documentation requirements and documentation integrity principles.
• Ability to collaborate effectively with physicians, executive leadership, operational departments, clinical operations, finance, compliance, revenue cycle, clinical documentation integrity, and information technology.
• Strong analytical skills with experience utilizing coding productivity, quality, reimbursement, denial, and audit data to drive operational improvements.
• Demonstrated leadership in change management, process improvement, and technology implementation.

Job Location
The Valley Health System-Ridgewood

Shift
Day (United States of America)

Benefits

• Medical/Prescription, Dental & Vision Discount Program (Full Time/Part Time Employees)
• Group Term Life Insurance and AD&D(Full Time Employees)
• Flexible Spending Accounts and Commuter Benefit Plans
• Supplemental Voluntary Benefits ( e.g. Short-term and Long-term Disability, Whole Life Insurance, Legal Support, etc.)
• 6 Paid Holidays, Paid Time Off (varies), Wellness Time Off, Extended Illness
• Retirement Plan
• Tuition Assistance
• Employee Assistance Program (EAP)
• Valley Health LifeStyles Fitness Center Membership Discount
• Day Care Discounts for Various Daycare Facilities

Salary

Joining Valley Health System means becoming part of a dedicated team that values the highest quality of care in a supportive environment. In our commitment to high performance and reliability, we encourage and recognize exceptional individual performance through our industry leading compensation practices including a starting salary and benefits in accordance with your role, experience, education, and licensure. Actual individual salaries vary depending on these factors. The salary listed does not include other forms of compensation or benefits.

Pay Range: $108,784.00 - $135,990.40

The posted pay range reflects the compensation for a full-time equivalent (1.0 FTE)