Revenue Integrity Coding Manager

Beth Israel Lahey Health; Boston (MA); On-site; USD 93,000 - 125,000; Full time

Job summary

Beth Israel Lahey Health in Boston is seeking a senior coding and billing leader to guide the department’s compliance with CMS and federal programs. You will oversee coding and auditing activities, develop coverage models, and drive process improvements to optimize reimbursements.

You will mentor coders, present audit results, and coordinate education for physicians and nurses on documentation guidelines, codes, and medical necessity.

Qualifications

• High School diploma or GED required; Bachelor's degree preferred.
• Certified Professional Coder (CPC) required.
• 5–8 years related work experience.
• Advanced skills with Microsoft applications (Outlook, Word, Excel, PowerPoint or Access) and other web-based applications.

Responsibilities

• Oversees coding team scope, direction, and effectiveness to support compliant coding and billing.
• Develops coverage models and cross-trains staff across specialties; communicates regulatory changes.
• Samples documentation to ensure coding and billing compliance; analyzes data to identify improvements.
• Monitors and mitigates billing/coding inefficiencies; analyzes audits, denials, and corrective actions.
• Presents audit results; conducts training on coding guidelines, medical necessity and modifiers.
• Plans daily coding team activities; provides feedback and may advise on hiring and performance reviews.
• Acts as HMFP audit point person; coordinates with HMFP Compliance to promote compliant billing.
• Provides coding services to divisions; collaborates with billing services to resolve denials.
• May perform additional duties to attain revenue cycle goals and optimize reimbursement; develops performance metrics.

Skills

Microsoft Office

Education

High School diploma or GED

Bachelor's degree

Certified Professional Coder (CPC)

Certified Professional Compliance Officer (CPCO)

Job description

Beth Israel Lahey Health in Boston is seeking a senior coding and billing leader to guide the department’s compliance with CMS and federal programs. You will oversee coding and auditing activities, develop coverage models, and drive process improvements to optimize reimbursements.

You will mentor coders, present audit results, and coordinate education for physicians and nurses on documentation guidelines, codes, and medical necessity.