Inpatient Coding Quality Manager

HMS Huron Managed Services LLC; Chicago (IL); On-site; USD 90,000 - 130,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision coverage

401(k) match

Paid time off

Parental leave

Job summary

Huron Consulting Group seeks an Inpatient Coding Quality Manager to lead coding quality auditing for IPDRG, ensure regulatory compliance, and drive accurate DRG assignments. You will supervise staff, address denials, and partner with billing, HIM, and clinical teams to optimize reimbursement and documentation accuracy.

The role requires CCS AHIMA certification, a health information management degree, and extensive experience with Epic or 3M Encoder.

Qualifications

• Inpatient IPDRG coding experience required.

Responsibilities

• Oversee daily coding quality auditing for inpatient IPDRG.
• Monitor staff productivity, accuracy, and turnaround times.
• Address denials and collaborate with billing/A/R teams.
• Provide coder education on updates and audits.
• Coordinate with physicians and HIM/Clinical teams to ensure accurate documentation.

Skills

IPDRG coding

DRG assignment

HCCs

NCCI edits

Medical necessity concepts

Regulatory knowledge

Leadership/mentoring

Communication skills

Education

CCS AHIMA certification

Associate or Bachelor’s in Health Information Management or related field

Tools

Epic

3M Encoder

Job description

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. 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.

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. 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:

• 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.

Position Level Manager Country United States of America

At Huron, we’re redefining what a consulting organization can be. We go beyond advice to deliver results that last. We inherit our client’s challenges as if they were our own. We help them transform for the future. We advocate. We make a difference. And we intelligently, passionately, relentlessly do great work…together. Are you the kind of person who stands ready to jump in, roll up your sleeves and transform ideas into action? Then come discover Huron. Whether you have years of experience or come right out of college, we invite you to explore our many opportunities. Find out how you can use your talents and develop your skills to make an impact immediately. Learn about how our culture and values provide you with the kind of environment that invites new ideas and innovation. Come see how we collaborate with each other in a culture of learning, coaching, diversity and inclusion. And hear about our unwavering commitment to make a difference in partnership with our clients, shareholders, communities and colleagues.

Huron Consulting Group offers a competitive compensation and benefits package including medical, dental, and vision coverage to employees and dependents; a 401(k) plan with a generous employer match; an employee stock purchase plan; a generous Paid Time Off policy; and paid parental leave and adoption assistance. Our Wellness Program supports employee total well-being by providing free annual health screenings and coaching, bank at work, and on-site workshops, as well as ongoing programs recognizing major events in the lives of our employees throughout the year. All benefits and programs are subject to applicable eligibility requirements.

Huron is fully committed to providing equal employment opportunity to job applicants and employees in recruitment, hiring, employment, compensation, benefits, promotions, transfers, training, and all other terms and conditions of employment. Huron will not discriminate on the basis of age, race, color, gender, marital status, sexual orientation, gender identity, pregnancy, national origin, religion, veteran status, physical or mental disability, genetic information, creed, citizenship or any other status protected by laws or regulations in the locations where we do business. We endeavor to maintain a drug-free workplace.