Manager, Coding, Revenue Integrity and Provider Engagement

Job Title:
Manager, Coding, Revenue Integrity and Provider Engagement

Job Description

Founded in 1991, IBJI is the largest orthopedic group practice in Illinois. With more than 150 physicians in every orthopedic specialty, IBJI offers care for adults and children from some of the most accomplished and respected orthopedists in the country. Serving northern Illinois and northwest Indiana with over 100 locations, IBJI makes it easy to access care. Our headquarters is in Park Ridge, Illinois, a northwest suburb of Chicago.

Our clinical services include advanced MRI imaging, pain management, non-surgical and surgical treatment plans, rheumatology, physical therapy, occupational therapy, wellness, and sports and sports training. Ortho Access walk-in clinics provide same day care for orthopedic injuries. Comprehensive care offered all in one place enables physicians, therapists and staff to work closely together, so that patients and families achieve better outcomes. Collaborative care is also more efficient.

In many cases, IBJI services are substantially less expensive than those provided by large healthcare systems and emergency rooms.

Summary

The Manager, Coding, Revenue Integrity & Provider Engagement provides leadership and oversight for professional coding, coding-related revenue integrity, provider education, and physician revenue cycle support across Illinois Bone & Joint Institute (IBJI). This role establishes consistent coding standards, oversees outsourced coding services, monitors coding quality and performance, identifies revenue integrity opportunities, and ensures coding practices support accurate and compliant reimbursement. The Manager serves as a key connection between Revenue Cycle and IBJI physicians and advanced practice providers, translating coding, documentation, reimbursement, and revenue cycle trends into clear, actionable information.

The position moves beyond individual account resolution to identify patterns, strengthen processes, develop education, and work collaboratively with providers, operational leaders, Revenue Cycle teams, Compliance, Information Technology, and external coding partners.

Responsibilities

• Provide overall leadership for professional coding operations, coding quality, coding standards, and coding related workflow across IBJI
• Establish and maintain standardized coding practices consistent with CPT, HCPCS, ICD-10-CM, CMS, NCCI, payer requirements, and applicable regulatory guidance
• Provide oversight of outsourced coding services, including service levels, turnaround times, quality, productivity, escalation processes, and contractual performance
• Partner with coding supervisors and external coding vendors to maintain appropriate coding workflow and timely charge submission
• Oversee coding work queues, coding edits, provider queries, charge corrections, and other coding-related exception processes
• Analyze coding related denials to identify trends, root causes, provider education opportunities, payer issues, system configuration concerns, and process gaps
• Partner with other Revenue Cycle leaders to ensure coding related denials are addressed consistently and appropriately
• Identify opportunities for appropriate revenue capture while maintaining compliant coding practices
• Evaluate trends involving modifiers, bundling edits, medical necessity, procedure coding, documentation, charge capture, and other areas affecting reimbursement
• Establish processes for reviewing potential under coding, over coding, missed charges, inappropriate edits, and other revenue integrity concerns
• Work with Epic and Revenue Cycle teams to identify system or workflow changes that can prevent recurring coding and charge capture issues
• Establish a structured coding quality program that includes routine audits, targeted reviews, trend analysis, and measurable quality expectations
• Partner with Compliance on coding concerns, regulatory interpretation, audit findings, and corrective action when appropriate
• Develop and maintain coding policies, procedures, reference materials, and standardized workflows
• Develop a structured provider education program focused on documentation, coding, reimbursement, medical…