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Manager, Coding Denials
HealthriseManager of Coding Denials overseeing coding-related denials at Healthrise. Leading a team, coaching staff, and ensuring compliance with coding guidelines and quality standards.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in coding methodologies including DRG, CPT, HCPCS, and ICD-10, while effectively leading and mentoring coding teams to enhance performance and reduce denials. Proficient in utilizing Epic or similar EHR/coding platforms to ensure accuracy and compliance.
Highest-signal resume keywords
Active Coding Credential (CCS, CCS-P, CPC, COC, CIC, RHIA, RHIT)5+ Years of Coding ExperienceStrong Knowledge of DRG, CPT, HCPCS, ICD-10Proficiency in Epic or Comparable EHR/Coding PlatformsCertified Revenue Cycle Professional (CRCP)
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
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Hard Skills
DRG CodingCPT CodingHCPCS CodingICD-10 CodingCoding AuditsDenial ManagementRevenue RecoveryPerformance Metrics MonitoringCoaching and Development
Soft Skills
LeadershipMentoringCoachingCommunication
Tools & Technologies
EpicEHR Platforms
Certifications & Qualifications
CCSCCS-PCPCCOCCICRHIARHITCRCP
Industry Keywords
Health Information ManagementRevenue CycleCoding DenialsQuality AuditsRegulatory Compliance
About the role
Key responsibilities & impact- Lead the day-to-day performance of a coding team with a primary focus on identifying, resolving, and preventing coding-related denials across DRG, CPT, HCPCS, and ICD-10 coding.
- Monitor broader productivity and quality metrics, coaches and develops coding staff.
- Serve as the first point of escalation for complex coding questions and documentation issues.
- Partner with revenue cycle and appeals teams to reduce denial volume and recover revenue.
- Conduct performance reviews and regular coaching.
- Perform regular quality audits of team coding accuracy across DRG, CPT, HCPCS, and ICD-10 assignment.
- Identify trends contributing to denials or revenue variance within the team's work and escalate findings to the Director of Coding.
Requirements
What you’ll need- Active coding credential required, such as CCS, CCS-P, CPC, COC, CIC, RHIA, or RHIT (AHIMA or AAPC), or equivalent.
- Minimum 5 years of coding experience, including experience leading, mentoring, or informally supervising other coders.
- Strong working knowledge of DRG, CPT, HCPCS, and ICD-10 coding methodologies.
- Proficiency in Epic or comparable EHR/coding platforms.
- Completion of regulatory/mandatory certifications as required.
- Willingness and ability to travel to client or organizational sites as needed.
- Bachelor’s degree in Health Information Management or related field is preferred.
- Certified Revenue Cycle Professional (CRCP) or equivalent industry certification is preferred.
Benefits
Comp & perks- Healthrise Core Values in all interactions with team members, clients, and stakeholders.
- Daily workflow and assignment of coding queues to ensure productivity and turnaround targets are met.
- Regular coaching and leads onboarding and training for new coding staff.
- Coordinates with third party coding vendor staff assigned to the team, monitoring day-to-day quality and SLA performance.
- Serves as a resource and mentor for staff navigating complex coding scenarios, building team capability over time.
- Regular quality audits of team coding accuracy across DRG, CPT, HCPCS, and ICD-10 assignment, providing feedback and coaching based on findings.
- First point of escalation for complex coding questions, denials, or documentation queries raised by the team.
- Ensures team compliance with coding guidelines, payer requirements, and regulatory standards, staying current on relevant coding and billing updates.
- Maintains coding productivity and quality reporting and dashboards for the team, including denial volume, turnaround time, and resolution outcomes.