Coding Manager, DRG Validator

Jobtailor; City of White Plains (NY); On-site; USD 120,000 - 150,000; Full time

Job summary

Jobtailor in White Plains, NY seeks an experienced HIM professional to lead the inpatient coding function, drive DRG reimbursement quality, and ensure regulatory compliance across the department.

The role requires guiding a coding team, improving data accuracy, and coordinating with patient accounting while maintaining high standards of performance and staff development.

Qualifications

• Bachelor degree required.
• CCS Certification required.
• RHIA or RHIT credential preferred.
• Minimum seven (7) years of coding experience.
• At least five (5) years of coding management experience in an acute care hospital HIM department.
• Extensive exposure to CPT-4 and ICD-10-CM-PCS coding, data entry, and clinical documentation.
• DRG validation experience.
• Excellent understanding of coding guidelines.
• In-depth understanding of MS-DRG and APR-DRG groupers.
• Ability to promote teamwork among HIM staff.
• Leadership skills and ability to empower staff to establish bidirectional communication.
• Excellent organizational, judgment, communication, and problem-solving techniques.
• Stress tolerance.

Responsibilities

• Oversee daily operations of the HIM Department, including inpatient coding.
• Manage processes for abstracting clinical information from electronic health records and assigning diagnosis and procedure codes.
• Create consistency and efficiency in inpatient claims processing and data collection to optimize DRG reimbursement and data quality.
• Ensure timely transmission of coded data to the Patient Accounts Department.
• Serve as a hospital resource on coding and DRG reimbursement.
• Oversee compliance reviews, especially inpatient cases, and initiate education or corrective actions.
• Share coding review findings with coders regularly.
• Ensure compliance with state regulatory and accreditation standards.
• Interview, hire, train, evaluate, counsel, and terminate employees according to hospital policy.
• Conduct staff meetings and participate in committees, task forces, and projects.
• Facilitate work with outside agencies on coding/CDI documentation improvement initiatives.
• Manage personnel and monitor HIM budgets while supporting department goals.
• Assist staff, ensure process standards, accuracy, and turnaround-time commitments.
• Identify and implement approved process improvements, troubleshoot issues, solve problems, and elevate appropriately.
• Perform other related duties as assigned.

Skills

Inpatient Coding

Clinical Documentation

CPT-4 and ICD-10-CM-PCS

MS-DRG & APR-DRG Groupers

Data Entry

Abstracting Clinical Information

Coding Guidelines

Leadership

Teamwork Promotion

Problem-Solving

Education

Bachelor Degree

CCS Certification

RHIA or RHIT (preferred)

Tools

MS-DRG Groupers

APR-DRG Groupers

HIM Software

Job description

• Oversee daily operations of the HIM Department, including inpatient coding
• Manage processes for abstracting clinical information from electronic health records and assigning diagnosis and procedure codes
• Create consistency and efficiency in inpatient claims processing and data collection to optimize DRG reimbursement and data quality
• Ensure timely transmission of coded data to the Patient Accounts Department
• Serve as a hospital resource on coding and DRG reimbursement
• Oversee compliance reviews, especially inpatient cases, and initiate education or corrective actions
• Share coding review findings with coders regularly
• Ensure compliance with state regulatory and accreditation standards
• Interview, hire, train, evaluate, counsel, and terminate employees according to hospital policy
• Conduct staff meetings and participate in committees, task forces, and projects
• Facilitate work with outside agencies on coding/CDI documentation improvement initiatives
• Manage personnel and monitor HIM budgets while supporting department goals
• Assist staff, ensure process standards, accuracy, and turnaround-time commitments
• Identify and implement approved process improvements, troubleshoot issues, solve problems, and elevate appropriately
• Perform other related duties as assigned

Requirements

• Bachelor Degree required
• CCS Certification required
• RHIA or RHIT credential preferred
• Minimum of seven (7) years of coding experience
• At least five (5) years of coding management experience in an acute care hospital Health Information Department
• Extensive exposure to CPT-4 and ICD-10-CM-PCS coding, data entry, and clinical documentation
• DRG validation experience
• Excellent understanding of coding guidelines
• In-depth understanding of MS-DRG and APR-DRG groupers
• Ability to promote teamwork among HIM staff
• Leadership skills and ability to empower staff to establish bidirectional communication
• Excellent organizational, judgment, communication, and problem-solving techniques
• Stress tolerance
• Manual dexterity for computer keyboard and mouse use
• Ability to sit at a computer terminal for extended periods daily
• Ability to walk to different areas inside and at offsite locations
• Ability to concentrate during increased noise levels and temperature changes

Core Competencies

Demonstrates expertise in HIM operations, including inpatient coding, compliance with regulatory standards, and DRG reimbursement optimization. Proven leadership in managing coding teams, ensuring data quality, and implementing process improvements.

Highest-signal resume keywords

• CCS Certification
• Inpatient Coding Management
• CPT-4 and ICD-10-CM-PCS Coding
• DRG Validation Experience
• Leadership Skills

ATS Optimization Keywords

Hard Skills

• Inpatient Coding
• Clinical Documentation
• Data Entry
• Coding Guidelines
• MS-DRG and APR-DRG Groupers
• Abstracting Clinical Information
• Claims Processing
• Compliance Reviews
• Process Improvement
• Budget Management

Soft Skills

• Teamwork Promotion
• Organizational Skills
• Communication Skills
• Problem-Solving Techniques
• Stress Tolerance

Certifications & Qualifications

• CCS Certification
• RHIA Credential
• RHIT Credential

Industry Keywords

• Health Information Management
• DRG Reimbursement
• State Regulatory Standards
• Accreditation Standards
• Acute Care Hospital