JOB SUMMARY:
The Coding Manager is responsible for overseeing and managing coding operations within a Federally Qualified Health Center (FQHC), ensuring the accurate and compliant assignment of CPT, ICD-10, and HCPCS codes in accordance with CMS, HRSA, and payer requirements. The Coding Manager supervises the Medical Documentation Specialist, who liaises with providers to ensure clinical documentation supports accurate coding, reimbursement, and regulatory reporting, including UDS measures.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other assignments, projects, and duties may be required:
1. Provide leadership and supervision to the medical coding team, ensuring accurate and timely coding of encounters by ICD-10, CPT, and HCPCS standards and CMS, HRSA, and payer-specific guidelines.
2. Supervise the Medical Documentation Specialist and ensure effective collaboration between providers, coders, and billers to support compliant documentation and optimal coding outcomes.
3. Collaborate with clinical providers to enhance documentation quality and accuracy, supporting compliant billing, appropriate risk stratification, and accurate Uniform Data System (UDS) reporting.
4. Partner with AI coding vendors to validate automated coding outputs, ensuring alignment with current coding standards and improving overall coding efficiency.
5. Coordinate with Clinical Care Coordinators to ensure coding practices support value-based care models, risk adjustment accuracy, and timely closure of care gaps.
6. Conduct routine internal coding audits and chart reviews to monitor accuracy, identify trends, and implement corrective actions supporting compliance and data integrity.
7. Maintain current knowledge of federal, state, and payer coding regulations and update internal protocols and workflows to ensure compliance and operational consistency.
8. Design and deliver ongoing training for providers and coding staff on documentation improvement, regulatory changes, and best practices for accurate and compliant coding.
9. Monitor coding productivity, accuracy, and quality metrics; develop and implement performance improvement plans to meet departmental and organizational benchmarks.
10. Collaborate with billing, clinical, quality, and compliance teams to enhance communication, improve documentation workflows, and ensure alignment between coding practices and organizational goals.
11. Provide coding guidance to medical departments about specialty coding and telehealth services.
SUPERVISORY RESPONSIBILITIES:
Supervises assigned coding staff, clinical documentation specialist, and related support personnel.
QUALIFICATIONS:
* A high school diploma or equivalent is required.
* Certified FQHC Coder.
* Demonstrated proficiency in ICD-10, CPT, and HCPCS coding systems, with an in-depth understanding of current coding guidelines, CMS requirements, and payer-specific rules.
* Familiarity with HRSA and UDS reporting requirements, including coding elements related to clinical quality measures and value-based care programs.
* Experience with electronic health record (EHR) systems and automated coding tools, including collaboration with AI-supported coding platforms.
* Strong leadership, communication, and analytical skills, with the ability to train, audit, and support staff to ensure compliance and accuracy.
* Proven experience working with vendors to improve AI-driven coding decision-making, including validating outputs and implementing improvements.
* Ability to collaborate with providers, clinical support staff, revenue cycle teams, and external partners to ensure accurate documentation and optimal coding outcomes.
To apply please email your resume to the reply link or fax to 855-832-3504, attention Human Resources. We are an equal opportunity employer and drug-free workplace.