Inpatient Coding Quality Manager

Accountabilities

• Oversee day-to-day inpatient coding quality operations, ensuring accurate, timely, and compliant coding for inpatient diagnosis-related group (IPDRG) services.
• Supervise and support inpatient coding quality audit staff, including recruitment, onboarding, scheduling, coaching, and performance management.
• Monitor team productivity, coding accuracy, and turnaround times to ensure operational targets are achieved.
• Ensure timely resolution of coding-related edits, billing holds, and documentation issues.
• Conduct coding audits and accuracy reviews to verify compliance with ICD-10 guidelines and applicable CMS and OIG regulations.
• Address coding-related denials and collaborate with billing and accounts receivable teams to identify root causes and implement corrective actions.
• Maintain up-to-date coding quality policies and procedures in line with regulatory requirements and accepted industry practices.
• Monitor regulatory and coding updates and communicate relevant guidance to team members.
• Collaborate with Health Information Management (HIM), Revenue Integrity, Clinical Documentation Improvement (CDI), Billing, and clinical departments to support clean claim generation.
• Coordinate with IT teams to optimize encoder, electronic health record (EHR), and computer-assisted coding (CAC) systems.
• Work with global coding teams and maintain effective relationships with multiple clients simultaneously.
• Serve as a client-facing leader, providing accurate performance reporting and ensuring consistent completion of client coding calibration activities.
• Deliver regular coder education on coding updates, documentation requirements, and audit findings.
• Mentor coding quality auditor leads and senior auditors, supporting career development and succession planning.
• Partner with physicians, nurses, and other healthcare professionals to improve documentation accuracy and obtain clarification when necessary.

Requirements:

• Associate or bachelor’s degree in Health Information Management, Healthcare Administration, or a related field.
• At least 5 years of inpatient (IPDRG) coding experience, including 2 or more years in a coding leadership role.
• Active and up-to-date Certified Coding Specialist (CCS) certification from AHIMA.
• Experience with Epic, 3M Encoder, or other leading electronic health record and coding systems.
• Previous experience managing remote coding teams.
• Strong knowledge of DRG assignment, Hierarchical Condition Categories (HCCs), National Correct Coding Initiative (NCCI) edits, and medical necessity concepts.
• Current permanent authorization to work in the United States.
• Experience analyzing and working with data from multiple sources.
• Strong communication and collaboration skills, with the ability to build effective working relationships across clinical, operational, and client teams.
• Ability to manage competing priorities and support multiple clients in a dynamic environment.
• Strong organizational, problem-solving, and team leadership capabilities.

Benefits:

• Estimated annual salary range of $90,000–$130,000, depending on skills, certifications, experience, market conditions, and other relevant factors.
• Eligibility to participate in an annual incentive compensation program aligned with performance.
• Medical, dental, and vision coverage.
• Access to additional wellness programs.
• Fully remote work arrangement within the United States.

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