RCM Coding SupervisorJob SummaryThe Revenue Cycle Management (RCM) Coding Supervisor is responsible for overseeing coding operations and ensuring the accuracy, quality, compliance, and efficiency of physician coding activities. This role serves as the primary liaison between VillageMD, outsourced coding vendor(s), providers, and internal stakeholders to support compliant coding and billing practices. The Coding Supervisor provides leadership, guidance, auditing, reporting, and process improvement oversight to optimize coding performance and mitigate organizational risk while ensuring adherence to federal, state, payer, and organizational requirements.
Essential Duties and ResponsibilitiesCoding Operations & Vendor Oversight- Serve as the primary point of contact for outsourced coding vendor(s), providing direction, performance feedback, and ongoing operational support.
- Monitor vendor productivity, quality, service levels, and turnaround times to ensure contractual and organizational expectations are met.
- Conduct routine audits and quality reviews to verify accurate assignment of Evaluation and Management (E/M) levels, CPT-4, and ICD-10 diagnosis codes.
- Collaborate with providers and clinical teams regarding documentation requirements and coding best practices.
- Identify coding trends, operational risks, and opportunities for process improvement.
Compliance & Quality Assurance- Develop, implement, and maintain coding policies, procedures, and documentation standards aligned with organizational strategy and regulatory requirements.
- Research, interpret, and communicate coding and billing regulations, payer requirements, and compliance guidelines.
- Investigate coding concerns, denials, and compliance-related inquiries, providing recommendations and resolution strategies.
- Partner with Compliance, Revenue Cycle, Clinical Leadership, and Operations teams to ensure coding practices meet regulatory and organizational standards.
- Maintain current knowledge of industry changes, including Medicare regulations, payer policies, National Correct Coding Initiative (NCCI) edits, and Local Coverage Determinations (LCDs).
Reporting & Performance Management- Analyze claims, audit, and coding performance data to establish benchmarks and identify coding vulnerabilities.
- Prepare and present audit results, compliance findings, and operational reports to leadership.
- Develop corrective action plans and monitor effectiveness through ongoing audits and follow-up reviews.
- Track key performance indicators (KPIs) related to coding quality, accuracy, productivity, and compliance.
Leadership & Team Support- Provide day-to-day guidance, coaching, and support to coding staff and vendor partners.
- Foster a culture of accountability, continuous improvement, teamwork, and customer service.
- Assist with onboarding, training, and education initiatives related to coding and documentation requirements.
- Promote professional and respectful communication across all levels of the organization.
- Demonstrate compassion, professionalism, and adherence to company policies and procedures in all interactions.
QualificationsEducation- High School Diploma, GED, or equivalent required.
- Associate's or Bachelor's degree in a healthcare-related field preferred.
Certifications- Current Certified Professional Coder (CPC) or Certified Coding Specialist-Physician Based (CCS-P) certification required.
- Certified Professional Medical Auditor (CPMA) or additional coding/compliance certifications preferred.
Experience- Minimum of 3 to 5 years of physician coding experience required.
- Previous experience conducting coding audits and supporting compliance initiatives required.
- Supervisory, team lead, vendor management, or project leadership experience preferred.
Knowledge, Skills, and Abilities- Expert knowledge of physician coding principles, including Evaluation and Management (E/M) services.
- Strong understanding of CPT®, ICD-10-CM, HCPCS, National Correct Coding Initiative (NCCI), and Medicare Local Coverage Determination (LCD) guidelines.
- Knowledge of healthcare compliance, payer regulations, and reimbursement methodologies.
- Proven analytical, organizational, and problem-solving skills.
- Ability to prioritize multiple responsibilities and meet deadlines in a fast-paced environment.
- Strong verbal, written, and interpersonal communication skills.
- Ability to work independently while collaborating effectively across departments.
- Demonstrated attention to detail and commitment to accuracy.
Physical Requirements- Ability to perform repetitive tasks, including keyboard and computer use.
- Manual dexterity sufficient to operate standard office equipment.
- Ability to sit and work at a computer for extended periods.
- Occasional standing, walking, and reaching may be required.
Work Environment- Primarily office or remote office environment.
- Frequent use of computer systems, coding software, and reporting tools.
- May require participation in meetings and training sessions with internal and external stakeholders.
Supervisory Responsibilities- Provides oversight and direction to outsourced coding vendor(s) and may provide functional supervision, training, coaching, and performance feedback to coding team members as assigned.
- Supports departmental leadership in achieving coding quality, productivity, compliance, and operational objectives.
Salary Range: This is an exempt position with a salary range of $74,000 - $92,000 depending on experience.
About Our CommitmentTotal Rewards at VillageMDOur team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMD's benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.
