Post-Acute Clinical Coding Manager

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.

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).

• Client Relationship Development Strategy
• Communication Skills
• Electronic Health Records
• HIPAA Training
• ICD
  10 Coding
• Inpatient Rehabilitation
• Interpers…