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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.
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.
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
DRG CodingCPT CodingHCPCS CodingICD-10 CodingCoding AuditsDenial ManagementRevenue RecoveryPerformance Metrics MonitoringCoaching and Development
Soft Skills
LeadershipMentoringCoachingCommunication
Certifications
CCSCCS-PCPCCOCCICRHIARHITCRCP