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Manager, Medical Billing & Coding

Manager, Medical Billing & Coding

Accordance Search GroupLivermore, CA, United States
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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.
  • Demonstrate strong knowledge of coding software and databases.
  • Verify that charges contain 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.
  • Provide timely and accurate answers to inquiries presented by customers about clinical coding issues.

REQUIRED QUALIFICATIONS

  • Minimum 7 years’ experience in Revenue Cycle Management including medical billing, change entry and coding
  • Hold active coding certification
  • PREFERRED QUALIFICATIONS

  • Bachelor’s degree in healthcare administration, business, or related field
  • Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification required.
  • Strong knowledge of healthcare reimbursement, payer policies, and regulatory compliance.
  • Experience with electronic health records (EHR), billing software, and revenue cycle management tools.
  • Excellent communication, analytical, and problem-solving skills.
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    Medical Billing Manager • Livermore, CA, United States

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