Medical Coding Manager

We are seeking a highly skilled and dynamic Medical Coding Manager with expertise in pediatric practice management to lead coding operations. This role is responsible for ensuring accurate coding practices company-wide, evaluating the appropriateness of CPT and ICD-10 codes assigned to each patient prior to claim submission, and providing input on coding workflows.

The manager will work closely with clinical providers to educate them on coding optimization and must be able to understand complex documentation related to value-based care.

Key responsibilities

• Oversee and manage coding operations for pediatric healthcare services while ensuring compliance with regulatory guidelines such as ICD-10, CPT, and CMS.
• Serve as the subject matter expert in pediatric coding for coding teams, clinicians, and administrative staff.
• Ensure accurate and timely coding before claim submission, with a focus on reducing denials and optimizing reimbursement.
• Conduct chart-to-bill audits to ensure proper codes are used for patient-specific visits.
• Act as a liaison between clinical and revenue cycle management teams.
• Stay current on AI technologies related to coding and healthcare billing.
• Collaborate with clinical documentation, IT, and data science teams to implement AI-driven coding solutions.
• Lead, mentor, and develop a team of coding professionals.
• Provide strategic oversight for coding activities and align them with organizational goals.
• Ensure adherence to HIPAA, CMS, and payer-specific requirements.
• Review and update coding policies and procedures regularly.