Manager - Professional Clinical Coding

MaineHealth Accountable Care Organization; Scarborough (ME); On-site; USD 83,000 - 113,000; Full time

Job summary

MaineHealth Corporate in Scarborough, ME is seeking a Manager of Revenue Integrity Data to lead the Clinical Data Section, oversee coding/abstracting of outpatient records, and prepare statistical analyses to support licensure and reimbursement processes.

The role requires RHIA/RHIT/CCS/CPC certification, EPIC experience, and strong leadership to ensure compliance with Federal/state regulations and provider-based payment systems.

Qualifications

• Two years of supervisory experience in a health information setting.
• Experience with EPIC, claim edits, encoder software, CDI programs preferred.
• Strong knowledge of ICD-10 and CPT coding; provider-based billing practices.

Responsibilities

• Manage Revenue Integrity Clinical Data Section.
• Code and abstract outpatient clinic records; prepare statistical analyses.
• Compile and analyze data from medical records for licensure and financial purposes.
• Support compliance with CMS, JCAHO, and other regulators.

Skills

Supervisory experience

EPIC experience

CPT/ICD-10 coding knowledge

Analytical skills

Education

RHIA/RHIT/CCS/CPC certification

Health Records Administration/Tech/Science degree

Tools

EPIC

Job description

Location: Scarborough, ME
Facility: MaineHealth Corporate
Schedule: Full Time
Shift: Day
Job Category: Management/Leadership
Req #: 83189
Date Posted: Sep 25, 2026

Summary:
This position manages Revenue Integrities Clinical Data Section, which is accountable for: coding and abstracting the medical records of Provider Based practice outpatient practice clinic claims i; preparing statistical analysis of medical records data; compiling, analyzing and summarizing data from medical records into various formats. The output of this Section is used for: meeting hospital licensure requirements; financial and billing purposes, which includes the identification and determination of appropriate reimbursement under inpatient and outpatient prospective payment systems; maintenance of acceptable accounts/receivables and Pre A/R levels; compliance with internal and external regulatory agencies, such as Quality Improvement Organizations, the Centers for Medicare & Medicaid Services, and The Joint Commission.

Required Minimum Knowledge, Skills, and Abilities (KSAs)

• Education: Advanced education which should include communication and mathematical/statistical skills and/or extensive knowledge in organization, research and analysis normally acquired through the completion of Health Record Administration/ Technician /Science Bachelor's/Associate Degree program, preferred.
• License/Certifications: Certification in one of the follow areas required: RHIA/RHIT, CCS, CPC. Skilled in ICD10 diagnosis and CPT coding and knowledge of Provider Based Billing practices.
• Experience: A minimum of two years prior successful supervisory experience required; Experience with EPIC, claim edit processes, encoder software and CDI programs, preferred.
• Full working knowledge of: medical information and revenue cycle systems; Grouper and Severity of Illness Systems; medical record systems, medical terminology, anatomy, physiology, pathophysiology, microbiology, and pharmacology; State, Federal and Joint Commission requirements pertaining to medical records; Provider Based payment systems, preferred.
• Demonstrated abilities to: correctly interpret and apply Federal regulations and PRO requirements in the interpretation of various billing guidelines (i.e., medical necessity, resident supervision policies, correct coding initiative, etc. Ability to direct concurrent and retrospective coding reviews and provide physician education, required
• Effective skills in leadership, communications, coaching, planning, motivation, and establishing effective working relationships with at all levels of staffing in the organization.

Additional Information

MaineHealth is committed to fostering a supportive, inclusive environment where care team members can thrive while making a meaningful impact in the communities we serve across Maine and New Hampshire. We offer competitive benefits including paid parental leave, flexible work options, student loan assistance, professional development opportunities, and well-being resources—so you can grow your career while feeling supported both personally and professionally.

We recognize the value each team member brings to our organization.Any offer of employmentwill depend onqualificationssuch asskills, relevant experience, education, certifications,and otherjob-relatedfactors. Thebase rangeis an estimate and does notreflect the full valueofourtotal compensationpackage.

The pay range for this position is $83,324.80to $112,736.00per year.

Compensation for part-time positions isdeterminedon a prorated basis consistent with the scheduled hours and applicable full-time equivalent (FTE).

In addition to base pay, MaineHealth offerscomprehensivebenefits, recognition programs, career growth opportunities, and,where applicable,shiftdifferentials or other incentives.

MaineHealth will never request financial information during the interview or pre-hiring process. All legitimate communications will come from an email address ending in @mainehealth.org. If you suspect fraudulent activity, please report it immediately to [email protected] .

Notice Regarding Maine Employer Surveillance Statute:

Pursuant to Maine's Employer Surveillance Statute, prospective care team members are notified that MaineHealth may monitor, collect, record, review, or retain information related to the use of its systems, networks, applications, files, data, communications platforms (including notified recordings), smart badges, building access, company vehicle GPS data, business calls, and workplace security cameras.

Information collected may be used for legitimate business purposes, including security, safety, compliance, investigations, training, quality assurance, and operational management.

MaineHealth policy requires all care team members to be vaccinated, including for influenza, subject to eligibility for medical or religious exemptions which can only be granted in compliance with applicable law.

Notice Regarding Maine Employer Surveillance Statute:

Pursuant to Maine's Employer Surveillance Statute, prospective care team members are notified that MaineHealth may monitor, collect, record, review, or retain information related to the use of its systems, networks, applications, files, data, communications platforms (including notified recordings), smart badges, building access, company vehicle GPS data, business calls, and workplace security cameras.

Information collected may be used for legitimate business purposes, including security, safety, compliance, investigations, training, quality assurance, and operational management.