Manager PB Coding Denials Integrity - Medical Specialties
Core
Lead and manage daily operations for professional coding denials integrity across multiple medical specialties including Laboratory, Pathology, Behavioral Health, and various clinical divisions.
Role type
Manager, Mid-Revenue Cycle Operations (Professional Coding Denials)
Builds
Standardized best practices and operational efficiency in the Mid-Revenue Cycle for professional coding and denials.
Domain
Healthcare / Revenue Cycle Management / Professional Coding
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Mid-Revenue Cycle operations expertise, Professional coding (facility and professional), HIM operational guidelines, Third-party reimbursement programs, Regulatory compliance (state/federal), Coding classification systems (ICD-10, CPT, HCPCS), Data analysis and KPI tracking, EHR systems proficiency, Process improvement and workflow optimization, Team leadership and development, Cross-functional collaboration.
Preferred skills
Dual certification in coding (AAPC/AHIMA), Experience in a large integrated healthcare system.
Technologies
EHR systems, Microsoft 365 (Teams, SharePoint, Word, Excel, PowerPoint, Access), Analytics tools.
Responsibilities
Lead and manage daily operations within the assigned function area, Evaluate processes to improve efficiency and enhance productivity, Ensure adherence to regulatory requirements and accreditation standards, Utilize key performance indicators (KPIs) to measure effectiveness and track trends, Engage with clinical, IT, Compliance, and Revenue Cycle leaders to integrate processes, Manage and develop a team of professionals including hiring and performance evaluations, Lead initiatives to improve operational effectiveness and drive system enhancements.
Seniority
Manager, 8+ years experience with 2+ years in leadership
