Drives improvements in documentation specificity to support reimbursement accuracy, risk adjustment, and quality reporting;
Supports value-based care, risk adjustment, and quality initiatives impacting reimbursement and patient outcomes;
Collaborates on payer audits, denials, and appeals to mitigate financial and compliance risk;
Leads continuous improvement efforts through data analysis, workflow redesign, and system optimization;
Operational & Compliance Oversight
Supervises pre-Accounts Receivable processes, including charge capture, coding accuracy, and timely encounter processing;
Provides guidance to clinical and billing staff regarding coding compliance and documentation standards;
Monitors coder work queues and reports to identify improvement opportunities;
Reviews work queues, charge sheets, and coding outputs for accuracy and appropriate pricing;
Conducts audits of coding and billing staff to ensure accuracy and compliance;
Identifies system issues and coordinates solutions with internal teams and vendors;
Staff Development & Training
Recruits, trains, and supervises coding staff;
Develops and maintains training materials and ensures ongoing staff education;
Coordinates implementation and training for coding updates and regulatory changes;
Ensures adherence to ODCHC policies and protocols;
Performs other duties as assigned by the Chief Financial Officer.
QUALIFICATIONS: The successful candidate will possess experience and skills spanning a variety areas:
Strong interpersonal and communication skills with the ability to collaborate across departments;
Knowledge of coding regulations, documentation requirements, and payer guidelines;
Ability to analyze complex information and translate it into actionable insights;
Proficiency in EHR, practice management systems, and reporting tools;
Coding Certification (COC, CPC, or CCS preferred);
At least seven years of experience in coding, clinical documentation improvement, billing, or auditing;
Experience in a community health center or similar healthcare environment;
Preferred Strategic Competencies
Experience implementing coding or revenue cycle improvement initiatives with measurable outcomes;
Understanding of Medicare, Medi-Cal, and Commercial reimbursement methodologies;
Experience with risk adjustment and/or value-based payment models;
Ability to use data to inform decision-making and drive performance improvement;
SUPERVISORY RESPONSIBILITIES: The Coding Manager supervises Charge Review Billers and Coders, including hiring, training, coaching, and performance evaluation.
This role is accountable for driving coding performance aligned with organizational financial and operational goals, including improvements in coding accuracy, denial reduction, and reimbursement outcomes.
SUPERVISION AND SUPPORT: Reports to the Revenue Cycle Manager and collaborates closely with Finance and Clinical leadership.
PHYSICAL REQUIREMENTS: This is largely an office-based position. The physical requirements described are representative of those needed to successfully perform the essential duties of the position. Reasonable accommodation will be made to allow otherwise qualified candidates to perform these functions.
Speaking and hearing sufficient to communicate effectively by telephone, video or in-person at normal volumes;
Vision adequate to read documents, computer screens, forms and designs and to differentiate colors as necessary;
Ability to travel locally and long-distance by car and air;
Ability to sit or stand for extended periods of time; and,
Ability to use keyboard and view computer screens for extended periods of time.
