Post-Acute Clinical Coding Manager

Omega Healthcare Management Services Pvt. Ltd.; Town of Florida, Northern (NY, KY); Hybrid; USD 120,000 - 180,000; Full time

Benefits offered by this job

Health, Dental, Vision

401(k) with employer match

Professional development opportunities

Paid time off

Holiday pay

Job summary

Omega Healthcare Management Services seeks a senior Coding Quality Leader to define and maintain master manuals for PDPM/PDGM and LTC. You will design standardized workflows and create templates for enterprise-wide use, ensuring consistent delivery across teams.

You will lead the audit framework, RCA efforts, and curriculum development for post-acute hires, acting as SME for complex coding issues and owning coding software. Strong CMS knowledge and leadership are essential.

Qualifications

• 10-12 years of progressive experience in medical coding, auditing, and compliance across SNF, Home Health and LTC environments.
• Proven success in client-facing roles such as pre-sales support, solution architecture, or functional delivery leadership in a BPO/outsourcing context.
• Deep knowledge of ICD-10-CM, CPT/HCPCS, MDS/RAI, PDPM, OASIS-E, PDGM, and audit frameworks (RAC, MAC, ADR).
• Strong understanding of CMS regulations, payer policies, HIPAA compliance.
• Credentials: AHIMA CCS/RHIA/RHIT or AAPC CPC.
• Preferred: CDIP, CCDS, CRC, COQS or equivalent; RN/PT/OT/SLP licensure a plus.

Responsibilities

• Define and maintain coding manuals for SNF, PDPM, PDGM, and LTC.
• Design standardized workflows for delivery teams to ensure consistency.
• Create templates, forms, and checklists for enterprise use.
• Design the audit framework (scorecard) for coding accuracy.
• Lead RCA when accuracy drops below 95% and develop corrective actions.
• Develop curriculum and certification for post-acute hires.
• Conduct Train-the-Trainer sessions on CMS regulations and payer policies.
• Serve as SME for complex coding gray areas and MQ rulings.
• Act as Functional Owner for coding software (Epic, CAC, AI tools).
• Collaborate with IT to optimize EHR templates and automated triggers.

Skills

Client Relationship

Communication

Electronic Health Records

HIPAA Training

ICD10 Coding

Inpatient Rehabilitation

Interpersonal Skills

Long-Term Care

Medical Terminology

Microsoft Office

Nursing Care

Occupational Therapy

Physical Therapy

Project Management

Skilled Nursing Facilities

Speech Language Pathology Assessments

Education

AHIMA CCS/RHIA/RHIT or AAPC CPC

CDIP, CCDS, CRC, COQS credentials

Nursing/Clinical background preferred

Tools

Epic

CAC

AI tools

Job description

Define and maintain the master coding manual for SNF (PDPM), Home Health (PDGM), and LTC.

Design the standardized workflows that all delivery teams must follow to ensure consistency.

Create solution accelerators (templates, query forms, and checklists) to be used across the enterprise.

Design the Audit Framework (the "scorecard") used to measure coding accuracy.

Perform high-level "Audit of the Auditors" to ensure that quality standards are being applied consistently across different teams.

Lead Root Cause Analysis (RCA) when accuracy drops below 95%, and design the corrective action plan for the operational teams to execute.

Develop the Curriculum and Certification requirements for all new hires in the post-acute space.

Conduct "Train-the-Trainer" sessions for operational leads to ensure they understand new CMS regulations or payer policies.

Serve as the SME for complex coding "gray areas" where delivery teams need a definitive ruling.

Act as the Functional Owner for coding software (e.g., Epic, CAC, AI tools).

Collaborate with IT to optimize EHR templates and ensure that automated coding tools are capturing the correct clinical triggers for reimbursement.

Key Success Indicators/Attributes

Strong analytical, critical thinking, and problem-solving capabilities.

Ability to collect, research, and synthesize complex and diverse information.

Excellent written, verbal and presentation skills.

Ability to build and maintain trust-based relationships with internal and external stakeholders.

Strong customer service orientation with a professional demeanor.

Demonstrated leadership and mentoring capabilities.

Able to prioritize and multi-task effectively in a complex, fast-paced environment.

Self-motivated with the ability to set goals, meet deadlines, and lead cross-functional initiatives.

Positive, adaptable, and able to support team decisions and organizational goals.

The physical demands described here are representative of those that must be met by an employee to

successfully perform the essential functions of this job.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; and talk or hear. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus .

Position Type/Expected Hours of Work

This is a full-time position. Days and hours of work are generally Monday through Friday, 8:00 a.m. to 5 p.m. This position occasionally requires long hours and weekend work.

Travel

Minimal travel up to 5%.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Employee may perform other duties as assigned.

Qualifications

Required Education and Experience

10-12 years of progressive experience in medical coding, auditing, and compliance, specifically within Skilled Nursing Facilities, Home Health and Long-Term Care environments.

Proven success in client-facing roles such as pre-sales support, solution architecture, or functional delivery leadership within a BPO/outsourcing context.

Deep, hands-on knowledge of ICD-10-CM, CPT/HCPCS, MDS/RAI and PDPM models, OASIS-E and PDGM models, and survey readiness and documentation strandards.

Strong understanding of CMS regulations, payer policies, HIPAA compliance, and audit frameworks (RAC, MAC, ADR).

Active AHIMA (CCS, RHIA, RHIT) or AAPC (CPC) credentials.

Preferred Education and Experience

CDIP, CCDS, CRC, COQS, or equivalent credentials are a plus.

Clinical background with RN, PT, OT, or SLP licensure is preferred.

Knowledge of Inpatient Rehabilitation Facilities (IRF-PAI and CMG models).

Required Skills

• Client Relationship Development Strategy
• Communication Skills
• Electronic Health Records
• HIPAA Training
• ICD10 Coding
• Inpatient Rehabilitation
• Interpersonal Skills
• Long-Term Care
• Medical Terminology
• Microsoft Office
• Nursing Care
• Occupational Therapy
• Physical Therapy
• Project Management
• Skilled Nursing Facilities
• Speech Language Pathology Assessments

About Us

Founded in 2003, Omega Healthcare Management Services® (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves more than 350 healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines. For more information, visitwww.omegahms.com

We offer a comprehensive benefits package that may include health, dental, and vision coverage, voluntary insurance options, a 401(k) plan with employer match, professional development opportunities, paid time off, and holiday pay. Eligible employees may also have the opportunity to participate in bonus programs, commissions, or other variable incentive plans. Benefits and incentive eligibility may vary based on position, location, and tenure.

AAP/EEO Statement

Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcarealso prohibits harassment of applicants or employees based on any of these protected categories.

Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources [e-mail] .