Manager Professional Coding

Kootenai Health; Coeur d'Alene (ID); On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Tuition assistance

Retirement plan with company match

Shift differentials for night/weekend

Job summary

Kootenai Health in Idaho seeks a Manager of Professional Coding to lead daily professional billing coding operations, ensure accurate documentation, and partner with clinic leaders to optimize reimbursement. You will oversee coding quality reviews, audits, and corrective actions while driving staff development and performance metrics.

The role emphasizes collaboration with Revenue Integrity, Compliance, and providers to maintain compliance with CMS and payer requirements and to improve

Qualifications

• Bachelor’s degree in health information management, healthcare administration, business administration, or related field.
• Master’s degree preferred.
• Minimum 3 years’ coding leadership or supervisory experience.
• Minimum 5 years’ professional coding experience.
• CPC, CPMA, CCS-P, or equivalent coding certification required.
• Strong knowledge of CPT, HCPCS, ICD-10-CM coding and provider documentation requirements.
• Experience with Epic or similar electronic health record system preferred.

Responsibilities

• Manages daily operations of professional coding teams across all employed physician practices and provider-based clinics
• Ensures coding activities are completed within established productivity and turnaround time standards
• Oversees work queues, coding edits, and charge-related issues to minimize claim delays and denials
• Monitors coding and charge capture performance and implements corrective action plans when necessary
• Maintains staffing plans and schedules to support operational needs
• Maintains compliance with CMS, OIG, commercial payer, and organizational coding requirements
• Coordinates corrective action plans and education based on audit findings
• Supports responses to payer audits and coding reviews
• Oversees charge capture processes for oncology infusion, injection, and related drug administration services to ensure accurate and timely billing

Skills

Leadership

Communication

Change management

Analytics

Education

Bachelor’s degree in health information management, healthcare administration, business administration, or related field

Master’s degree preferred

Tools

Epic

Job description

• Department Health Information Management - Coding

Position Summary

The Manager of Professional Coding is responsible for the day-to-day operations of Professional Billing (PB) Coding and Provider Documentation Education functions. This position ensures accurate, timely, and compliant coding and charge capture processes, supports revenue cycle performance, and promotes documentation integrity through staff oversight, education, auditing, and operational monitoring. The Manager partners closely with clinic leadership, Revenue Integrity, Compliance, Patient Financial Services, and providers to optimize coding quality, reimbursement, and regulatory compliance.

Responsibilities

• Manages daily operations of professional coding teams across all employed physician practices and provider-based clinics
• Ensures coding activities are completed within established productivity and turnaround time standards
• Oversees work queues, coding edits, and charge-related issues to minimize claim delays and denials
• Monitors coding and charge capture performance and implements corrective action plans when necessary
• Maintains staffing plans and schedules to support operational needs
• Ensures accurate assignment of CPT, HCPCS, and ICD-10-CM codes in accordance with payer and regulatory requirements
• Oversees coding quality reviews and internal audits
• Coordinates corrective action plans and education based on audit findings
• Maintains compliance with CMS, OIG, commercial payer, and organizational coding requirements
• Supports responses to payer audits and coding reviews
• Oversees charge capture processes for oncology infusion, injection, and related drug administration services to ensure accurate and timely billing
• Monitors compliance with CPT, HCPCS, medication administration, and payer-specific charging requirements, coordinating education and corrective actions as needed
• Partners with Cancer Center leadership, Revenue Integrity, Pharmacy, and Clinical Operations to improve charge capture accuracy, reduce missed charges, and optimize reimbursement
• Partners with providers and operational leaders to improved documentation and coding requirements
• Identifies documentation trends and opportunities for improvement
• Collaborates with Revenue Integrity and Compliance teams on coding and documentation initiatives
• Establishes and monitors productivity and quality metrics
• Provides coaching, mentoring, and performance management for coding staff and supervisors
• Conducts regular staff evaluations and development planning
• Promotes employee engagement and continuous learning
• Tracks and reports coding productivity, quality, denial trends, and financial impacts
• Provides operational reporting to Revenue Cycle leadership
• Assists with annual budgeting and resource planning activities
• Maintains knowledge of healthcare reimbursement methodologies and coding regulations
• Participates in departmental projects, process improvement initiatives, and system optimization efforts
• Relies on experience and judgment to plan and accomplish goals
• Regular and predictable attendance is an essential job function
• Performs other related duties as assigned
• Competent to meet age-specific needs of the unit assigned

Requirements and Minimum Qualifications

• High School diploma or equivalent required
• Bachelor’s degree in health information management, Healthcare Administration, Business Administration, or related field required; Master’s degree preferred
• Minimum 3 years’ of coding leadership or supervisory experience required
• Minimum 5 years’ of professional coding experience required
• CPC, CPMA, CCS-P, or equivalent coding certification required
• Strong knowledge of CPT, HCPCS, ICD-10-CM coding and provider documentation requirements
• Experience with Epic or similar electronic health record system preferred
• Proven ability to analyze operational and financial performance data and translate findings into actionable strategies
• Exceptional leadership, communication, relationship-building, and change management skills
• Experience with Epic and revenue cycle technology platforms preferred
• Ability to communicate data and complex topics to senior leadership and physicians

Working Conditions

• Must be able to lift and move up to 10 lbs
• Must be able to communicate and exchange accurate information
• Typical equipment used in an office job

Why I love my job as a leader at Kootenai Health

A variety of medical, dental, and vision insurance plans are available to both full and part-time employees, with some available at no cost to the employee. In addition, benefit-eligible employees also gain access to the following:

• Tuition assistance and career development programs
• Robust Retirement Plan
• Night, weekend and PRN shift differentials

What makes a successful employee at Kootenai Health?