Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients.
Joining the Huron team means you’ll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise. The US Inpatient Coding Quality Manager is responsible for the day-to-day operations and oversight of coding processes to ensure timely, accurate, and compliant assignment of diagnosis and procedure codes for inpatient (IPDRG) services. This leader ensures adherence to regulatory guidelines and payer requirements and supports optimal reimbursement through quality coding practices.
KEY RESPONSIBILITES
Operational Oversight
Supervise and support coding quality auditing staff (inpatient (IPDRG)) including hiring, onboarding, scheduling, and performance management.
Monitor coding quality auditing staff productivity, accuracy, and turnaround time for coding completion.
Ensure timely resolution of coding-related edits and billing holds.
Other duties as assigned.
Quality & Compliance
Conduct coding audits and accuracy reviews, ensuring compliance with ICD-10 and applicable CMS/OIG regulations.
Address coding-related denials and partner with billing and A/R teams to identify root causes.
Stay current with regulatory and coding updates and disseminate guidance to staff.
Ensure coding quality auditing policies & procedures are current and reflect the most compliant/accepted practices for medical coding.
Collaboration & Support
Work closely with HIM, Revenue Integrity, CDI, Billing, and Clinical departments to ensure clean claim generation.
Coordinate with IT on encoder, EHR, and CAC system optimization.
Collaborates with the Huron coding global teams.
Is client facing and ensures accurate performance reporting to client.
Ensures consistent client coding calibration completion.
Works with multiple clients at one time.
Education & Training
Provide regular coder education on coding updates, documentation changes, and audit findings.
Mentor coding quality auditor leads and/or senior coding quality auditors to support succession planning and career development.
Coordinating with Healthcare Providers
Work closely with physicians, nurses, and other healthcare professionals to ensure timely and accurate documentation that reflects the care provided to patients. Obtain clarification as appropriate.
Required Qualifications
Associate or Bachelor’s degree in Health Information Management, Healthcare Administration, or related field.
5+ years of experience in inpatient (IPDRG) coding; 2+ years in a coding leadership role.
Required: Active and up to date CCS AHIMA coding certification
Required Experience with Epic, 3M Encoder, or other leading EHR/coding systems.
Previous experience managing remote coding teams.
Strong knowledge of DRG assignment, HCCs, NCCI edits, and medical necessity concepts.
Current permanent U.S. Work Authorization required.
Experience working with data from various sources.
Strong communication skills and desire to work as part of a team in a partnership role.
Working with multiple clients at one time.
The estimated salary range for this job is $90,000- $130,000. The range represents a good faith estimate of the range that Huron reasonably expects to pay for this job at the time of the job posting. The actual salary paid to an individual will vary based on multiple factors, including but not limited to specific skills or certifications, years of experience, market changes and required travel. This job is also eligible to participate in Huron’s annual incentive compensation program, which reflects Huron’s pay for performance philosophy and Huron’s benefit plans which include medical, dental and vision coverage and other wellness programs. The salary range information provided is in accordance with applicable state and local laws regarding salary transparency that are currently in effect and may be implemented in the future.
- Country
- United States of America
