Lead, Revenue Integrity: Coding & Auditing

Stratum Med; Springfield (IL); On-site; USD 110,000 - 140,000; Full time

Job summary

Stratum Med is seeking a Revenue Cycle Coding & Auditing Manager to provide strategic and day-to-day leadership over coding, education, and billing compliance. The role oversees audits, education, and optimizes workflows to enhance reimbursement.

You will collaborate with Clinical Operations, Revenue Cycle and IT to safeguard compliance with federal/state regulations and payer policies. Reports to the Director of Revenue Integrity.

Qualifications

• Bachelor of Science in Health Information Management required.
• CPC, CCS-P, RHIA certifications required within the specified timelines.
• Strong leadership and collaboration skills with proven ability to drive change.

Responsibilities

• Lead coding and auditing staff; set goals and drive continuous improvement.
• Oversee daily workflows, queues, and staffing to meet productivity, quality and SLA standards.
• Manage budgets and forecast staffing/resources to support volume, accuracy, and compliance needs.
• Standardize policies, procedures, and controls for efficient operations.
• Institute and oversee coder audits; ensure high quality and accuracy of coding.
• Ensure timely, accurate, and compliant ICD-10-CM/PCS and CPT/HCPCS coding and charge capture.
• Partner with providers to improve documentation and medical necessity support.
• Oversee coding, billing, and documentation audits, including plans, sampling, scoring and corrective actions.
• Monitor claim editing and encoding systems; analyze denial trends and implement fixes.
• Establish monitoring to adhere to Medicare/Medicaid regulations and payer policies.
• Develop and deliver coding and billing education for staff, including onboarding.
• Publish guidance translating regulations into operational workflows.
• Analyze denials; lead root-cause analyses and prevention strategies.
• Collaborate with revenue cycle teams to improve first-pass yield and reduce denials.
• Recommend process and technology improvements to boost clean-claim rates and reduce A/R days.
• Monitor KPIs and present performance updates to leadership.
• Serve as SME on coding, compliance, and revenue cycle best practices.

Skills

Verbal & written communication

Strategic thinking

Analytical skills

Microsoft Office

Education

Bachelor of Science in Health Information Management

Master's degree in business or finance (preferred)

Tools

Auditing tools

Billing systems

Job description

Stratum Med is seeking a Revenue Cycle Coding & Auditing Manager to provide strategic and day-to-day leadership over coding, education, and billing compliance. The role oversees audits, education, and optimizes workflows to enhance reimbursement.

You will collaborate with Clinical Operations, Revenue Cycle and IT to safeguard compliance with federal/state regulations and payer policies. Reports to the Director of Revenue Integrity.