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Manager, Coding & Documentation Analysis
Elevance HealthManager overseeing coding team operations and documentation quality for CareBridge Health. Ensuring adherence to Medicare and Medicaid guidelines with a focus on high performance.
Tech Stack
Tools & technologiesSQL
About the role
Key responsibilities & impact- Responsible for leading coding team operations to drive high-quality documentation of clinical encounters and ensure adherence to the latest diagnostic documentation guidelines and clinical best practices.
- Serves as the primary resource and subject matter expert on all Medicare and Medicaid clinical documentation.
- Participates in all consultations related to coding and clinical documentation and creation of policy briefs for leadership.
- Executes day-to-day coding operations and ensures high-quality coding of diagnoses against ICD-10 and CPT classification systems.
- Drives high performance on coding team KPIs (e.g., turnaround times, claim denial rate due to technical issues, secondary review scores).
- Develops and iterates team workflows, KPIs, and associated reporting to meet quarterly goals for coding timeliness and quality.
- Maintains high performance through operational efficiency and ongoing business optimization.
- Develops and implements strategy for quality reviews of coder performance and associated coaching.
Requirements
What you’ll need- Requires a BA/BS and minimum 5 years coding leadership experience, or any combination of education and experience which would provide an equivalent background.
- Experience with various Risk Models including CMS is required.
- Experience with regulations relating to Medicare, Medicaid, and commercial insurance providers is required.
- Certified Medical Coder (CPC or CCS-P) is a must for this role.
- CPMA (Certified Professional Medical Auditor) and/or CRC (Certified Risk Adjustment Coder) certification preferred.
- Strong analytical skills, including experience conducting exploratory analyses in Microsoft Excel is preferred (bonus if SQL-savvy).
Benefits
Comp & perks- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical
- dental
- vision
- short and long term disability benefits
- 401(k) + match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
ICD-10CPTcoding operationsclinical documentationKPI developmentquality reviewsanalytical skillsexploratory analysesMicrosoft ExcelSQL
Soft Skills
leadershipoperational efficiencycoachingcommunicationteam managementstrategic developmentproblem-solvingcollaborationadaptabilityperformance optimization
Certifications
Certified Medical Coder (CPC)Certified Coding Specialist (CCS-P)Certified Professional Medical Auditor (CPMA)Certified Risk Adjustment Coder (CRC)