Coding Quality Manager

🔥 13 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🟠 Senior

🔴 Lead

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 11%

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nimble solutions

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

💼 Consulting

📦 Logistics

🛡️ Insurance

Consulting • Logistics • Insurance

nimble solutions is a company focused on innovative online solutions, offering services related to payment processing, account management, and invoicing. It leverages web-based technologies to provide efficient and user-friendly platforms for managing financial transactions and accounts. The company aims to simplify complex billing and payment processes for businesses.

📋 Description

• Perform prospective and retrospective audits of outpatient and professional surgical coding, including CPT, ICD-10-CM, modifier assignment, Official Coding Guidelines, NCCI/OCE edits, and payer policies • Support and maintain the coding quality assurance program, including audit methodologies, scoring, documentation standards, and quality tracking processes • Analyze audit results and quality trends to identify risk areas, educational needs, and process improvement opportunities • Develop and deliver targeted coder- and provider-facing education, including remediation, training sessions, and client-specific education • Prepare client-facing audit summaries and reports communicating quality scores, trends, and recommended actions • Collaborate with Coding Operations and cross-functional teams to optimize workflows, standardize best practices, and achieve quality and service-level expectations • Provide expert-level support for complex coding questions across Ambulatory Surgery Centers and Professional Fee services • Participate in quality and compliance initiatives, including follow-up audits, corrective-action monitoring, and validation of improvement outcomes • Contribute to special projects involving audits, quality improvement, workflow enhancements, client onboarding, and ongoing client support

🎯 Requirements

• 8–10+ years of coding experience, including outpatient and/or professional surgical coding • 5+ years of coding quality auditing and/or coding education experience • Advanced knowledge of CPT, ICD-10-CM, modifier usage, Medicare regulations, OPPS, and payer policies • Experience with surgical specialties such as orthopedics, spine, pain management, ophthalmology, and general surgery • Strong written and verbal communication skills, including client-facing education and presentation capabilities • Excellent analytical skills with the ability to interpret audit data and translate findings into actionable education • Highly organized with the ability to manage multiple priorities and meet deadlines in a fast-paced, remote environment • Self-directed, solution-oriented mindset with strong critical thinking and problem-solving abilities • Proficiency in Microsoft Excel, Word, PowerPoint, and SharePoint

🏖️ Benefits

• Opportunity to join a well-established and market-leading brand serving a high-growth end market • Valuable experience working closely with Executive leadership • Positive culture-building environment • Fully remote work arrangement

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