Coding Manager

Division: Revenue Cycle

Job Title: Coding Manager, QA Reviewer & Educator

Job Code:

Position Summary

The Coding Manager–Educator–Reviewer provides leadership and oversight for coding operations, ensuring accuracy, compliance, and continuous improvement across the organization. This role combines technical expertise with instructional skill to maintain high‑quality coding practices and support coder development.

The position is responsible for coding quality reviews and education, including accurate ICD‑10‑CM/PCS, DRG, and CPT assignment, adherence to national guidelines, and compliance with hospital policies. It delivers ongoing coder education, identifies coding quality trends, and collaborates closely with CDI to strengthen documentation integrity and support physician education.

In addition, the role supports HIM’s oversight of coding‑related denials and documentation quality, contributing to organizational compliance, revenue integrity, and improved clinical documentation outcomes.

Statement of Accountability 

Reports to: HIM Director 

Qualifications

· Education

· Licensure

· Work Experience

· Skills/computer/ specific technical

§ Other qualifications, miscellaneous

Specify if qualifications are Required or Preferred

1. Education

· Required: Associate’s degree in a healthcare related field or equivalent experience.

· Preferred: Bachelor’s degree in Health Information Management, or a related field or equivalent experience.

2. Licensure/Certification

· Required Credentials: 

o CCS, CPC, RHIT, RHIA or equivalent credential.

· Preferred: CCS and RHIA/RHIT credentials.

3. Work Experience

· Required:

o Minimum of 8 years of experience in acute care hospital inpatient coding.

o Minimum of 3 years in a leadership, auditing, or education role.

· Preferred: 

o Minimum of 10 years of experience in acute care hospital inpatient coding.

o Minimum of 5 years in a leadership, auditing, or education role.

4. Skills and technical competencies

• Extensive inpatient acute care coding experience.
• Strong knowledge of ICD‑10‑CM/PCS, DRG logic, coding guidelines, and CMS/payer requirements.
• Experience in coding quality review, DRG validation, and coder education.
• Effective communication skills and ability to collaborate with CDI, providers, and revenue cycle teams.
• Experience with EHR systems and coding software.
• Excellent communication, leadership, and instructional skills.
• Experience in hospital or multi-specialty coding environments.
• Background in curriculum development or adult learning methodologies.

5. Work Environment

• This is a remote position. On‑site presence may be required for meetings, training sessions, and other operational needs.
• Fast‑paced environment requiring accuracy, initiative, collaboration, and strong follow‑through.
• Ability to work independently in a remote setting with minimal supervision. 

Essential Job Responsibilities

Key Responsibilities

1. Coding Management

• Oversee daily operations of the coding department, including workload distribution, productivity monitoring, and performance management.
• Develop and implement coding policies, procedures, and best practices.
• Collaborate with clinical, billing, and compliance teams to resolve coding-related issues.
• Monitor coding quality, timeliness, and adherence to organizational standards.
• Support strategic planning for staffing, technology, and workflow optimization.

2. Education & Training

• Design and deliver training programs for new and existing coders, providers, and clinical staff.
• Create educational materials, including guides, presentations, and competency assessments.
• Provide ongoing coaching and mentorship to improve coding accuracy and confidence.
• Stay current with regulatory changes (ICD-10, CPT, HCPCS, CMS, payer updates) and disseminate updates across the organization.
• Lead workshops, refresher courses, and targeted training based on audit findings.

· Stay current with evolving coding standards and regulatory changes.

3. Coding Reviews & Compliance

• Conduct routine and targeted coding audits to assess accuracy, completeness, and compliance.
• Analyze audit results and prepare detailed reports with actionable recommendations.
• Identify trends, risks, and opportunities for improvement in coding practices.
• Work with compliance teams to ensure alignment with federal, state, and payer regulations.
• Develop corrective action plans and monitor follow‑up to ensure sustained improvement.