Manager, Medical Billing & Coding

Our Fortune 500 client is seeking a Manager of Medical Billing & Coding. In this newly created role, you will lead the strategy, operations, and compliance of medical billing and coding functions. This role ensures accurate, timely, and compliant billing practices, with a focus on optimizing revenue cycle performance, enhancing payer-provider alignment, and supporting patient satisfaction. The ideal candidate brings deep expertise in healthcare billing, coding standards (ICD-10, CPT, HCPCS), and payer regulations, along with strong leadership and cross-functional collaboration skills.

You will :

• Assure compliance with ICD-10-CM / PCS and CPT-4 rules and guidelines and implement CMS and Correct Coding Initiative Guidelines (CCI) while identifying areas of potential coding, billing and documentation deficiencies and potential compliance risk
• Support commercial and IT teams with coding guidance and change management processes.
• Request, review and code medical services from reports and notes to convert procedural and diagnostic notes into appropriate levels of care following coding rules and regulations.
• Demonstrate the ability to understand CMS NCD and LCD guidelines to support coding decision making
• Identify clinical documentation deficiencies and recommend methods for resolution that satisfy regulatory and compliance requirements.
• Perform medical chart audits meeting minimum department productivity standards.
• Demonstrate strong knowledge of coding software and databases.
• Increase knowledge of electronic data systems and reporting tools to enhance value.
• Participate in job-related conferences, seminars and workshops.
• Verify that each charge contains the necessary charge elements on EMR and Salesforce.
• Ensure all charges are entered correctly and accounted for and be able to perform charge entry and all other charge related procedures.
• Independently research coding questions, documents findings, make recommendations and provide documentation that supports the recommended solutions.
• Provide timely and accurate answers to inquiries presented by customers about clinical coding issues.

REQUIRED QUALIFICATIONS

PREFERRED QUALIFICATIONS