Manager, Coding & Quality

Summary

Join CodaMetrix as their Coding Quality Program Manager, a key role within the Medical Coding & Audit team. You will be responsible for ensuring CodaMetrix meets and exceeds customer coding quality expectations, leveraging your expertise in surgery and endoscopy billing and auditing. This position requires reviewing, analyzing, and enhancing coding processes, both internally and externally, and collaborating with cross-functional teams. The role demands strong communication skills to convey complex coding issues and solutions to various stakeholders. A commitment to continuous learning, quality, and innovation in medical coding practices is essential. You will lead and manage a team of medical coders, overseeing daily operations and ensuring compliance with coding standards.

Requirements

• Required AHIMA or AAPC coding credential held for 5+ years
• 5+ years of coding, auditing, or revenue cycle leadership experience with progressive growth in responsibilities, specifically in Surgery & Endoscopy coding
• Excellent communication and customer service skills, capable of effectively engaging executives, directors, data scientists, and other stakeholders with varying levels of coding knowledge
• Strong organizational and detail-oriented approach with a demonstrated commitment to excellence and precision
• Critical thinking, intellectual curiosity, and creativity in problem-solving
• Ability to thrive under time constraints in a fast-paced environment
• Team-oriented approach with a positive and patient demeanor, fostering collaboration and continuous improvement

Responsibilities

• Lead, manage, and support a team of medical coders specializing in surgical procedures
• Oversee daily coding operations to ensure accurate, compliant, and timely coding in line with CPT, ICD-10, and HCPCS standards
• Develop and implement quality assurance processes to reduce coding errors and support audit readiness
• Provide training, coaching, and mentorship to team members on surgical coding practices and regulatory updates
• Conduct regular performance evaluations and deliver constructive feedback to support continuous professional development
• Collaborate with customers, clinical documentation teams, and revenue cycle staff to resolve documentation discrepancies and improve coding accuracy
• Monitor team performance metrics and KPIs to drive productivity and identify opportunities for workflow optimization
• Ensure full compliance with HIPAA, CMS, payer-specific, and organizational coding policies
• Coordinate onboarding for new coders and facilitate ongoing education to maintain certification requirements and coding proficiency
• Participate in cross-departmental initiatives to improve coding practices and revenue cycle outcomes
• Analyze and document customers’ coding practices and workflows to facilitate optimal use of the CodaMetrix product
• Identify and share best practices for coding automation and workflow improvements
• Surface customer coding and Billing business processes that do not meet established best practices or conflict with the CMX product offering
• Manage Coding Quality Assessment (CQA) projects, including work assignments, training, and quality assurance for offshore coding staff
• Leverage CodaMetrix coding standards when responding to client requests or internal inquiries and use them to anchor responses on coding related questions to drive world-class coding quality and consistency
• Present audit results to customer stakeholders and facilitate sign-off for go-live milestones
• Serve as the internal and external Subject Matter Expert (SME) on medical coding and billing across assigned service lines, with a strong emphasis on Surgery and Endoscopy coding
• Provide expert guidance on coding and billing questions to support Machine Learning and Product teams
• Develop and deliver evaluation and training materials on coding and billing to colleagues and customers to build internal competencies and champion continuous improvement initiatives
• Proactively stay up to date with changes in medical coding and billing, as well as regulatory and payor policy changes to Surgery & Endoscopy coding, by maintaining relevant certifications and participating in ongoing education
• Uphold all legal and ethical requirements, ensuring accuracy, confidentiality, and compliance in all coding and audit activities
• Actively participate in customer implementations, providing coding expertise to ensure accurate and efficient deployment of CodaMetrix solutions
• Collaborate with cross-functional teams—such as Data Science, Product, and Customer Success—to address client needs and optimize results
• Primary resource for validating partner audit results and assigning overall quality to the CMX Surgery offering
• Oversight of outsource coding partners and their delivery of customer production coding results for Surgery visits

Benefits

• Health Insurance: We cover 80% of the cost of medical and dental insurance and offer vision insurance
• Retirement: We offer a 401(k) plan that eligible employees can contribute to one month after their first day
• Flexibility: We have a generous Paid Time Off policy, which is managed but not limited, so you can take the time you need to relax and rejuvenate
• Learning: All new hires complete our 7-week Onboarding Program where they learn about our company and each of our departments through live sessions hosted by a variety of our leaders
• Development: We provide annual performance evaluations and prioritize working with employees on what their individual growth looks like
• Recognition: We recognize the outstanding achievements of our team through annual company awards where employees have the opportunity to nominate their peers
• Office Location: A modern open plan workspace located in the bustling Back Bay neighborhood of Boston
• Additional Employer Paid Benefits: We offer employer-paid life insurance and short-term and long-term disability insurance