Senior Manager Coding IP OP

Responsibilities

  • Oversee daily inpatient and outpatient coding and reimbursement practices to ensure regulatory compliance
  • Develop and maintain standardized coding guidelines for inpatient and outpatient services
  • Review and analyze complex billing edits and claim reports to support accurate DRG and APC/APG assignments
  • Conduct routine data quality reviews of coded medical records for accuracy and consistency
  • Coordinate and deliver technical training and educational programs for coding staff
  • Manage institutional responses to external audits including RAC reviews and commercial payer audits
  • Resolve complex coding-related denial cases and prepare clinical appeals
  • Represent the Coding Department at interdisciplinary clinical meetings as a subject matter authority

Requirements

  • Bachelor's Degree in Health Information Management or a related field
  • Minimum of five years of acute care hospital coding experience with ICD-10-CM/PCS
  • At least three years of healthcare management experience
  • Certified Coding Specialist (CCS) credential

Preferred Qualifications

  • Five years of healthcare management experience in an academic medical setting or trauma center
  • Experience utilizing Current Procedural Terminology (CPT-4)
  • Registered Health Information Administrator (RHIA) credential
  • Registered Health Information Technician (RHIT) credential

About the Company

Boston Medical Center is a nationally recognized leader in health equity, dedicated to providing exceptional and equitable care to all. BMC is committed to improving the health of the community in Boston and beyond through teamwork, support, and excellence in clinical care.

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