Senior Manager Coding Audits & EducationChildren's National Medical Center • Silver Spring, MD, United States
Senior Manager Coding Audits & Education
Children's National Medical Center • Silver Spring, MD, United States
[job_card.30_days_ago]
[job_preview.job_type]
- [job_card.full_time]
[job_card.job_description]7+ years of progressive coding experience, with at least 3 years in a supervisory or management role. Demonstrated expertise in hospital inpatient, outpatient, and professional coding. Experience managing coding QA programs, education functions, and denial reduction initiatives. Strong understanding of federal and payer regulations, documentation requirements, and revenue cycle workflows. Strong understanding of coding processes, coding guidelines and their relation to the overall Revenue Cycle data flow / third party reimbursement. Ability to communicate professionally with physicians, third‑party payers and other organization members about coding principles and processes. Experience with 3M, Epic and / or Cerner Millennium. Excellent written and verbal communication skills. Demonstrated leadership and personnel management skills. Demonstrated change management skills. Maintains relationships with internal and external stakeholders. Commitment to compliance, accuracy, and high‑quality data reporting. Familiar with department budget and financial management, and personnel management. Familiarity with population health strategies, alternative payment models, and care coordination strategies (preferred). Certified Coding Specialist (CCS) upon hire (Required) or Similar Medical Coding Certification(s) – CIC and / or CPC. Strategic and Financial Planning – Contribute to the strategic plan for department services, including short‑term and long‑term objectives. Collect and analyze customer and stakeholder feedback, evaluate department effectiveness, and incorporate findings into plans. Work with Director, Vice President and other staff to develop ways to capture and report financial performance of the Department. Participate in financial planning and budget preparation. Work with Director to manage department budget to ensure financial stability of the department and develop recommendations to meet budget requirements. Work with financial personnel to monitor the financial performance of teams within the department to ensure compliance with budget; track, monitor, and evaluate budget for all line items. Leadership & Department Management – Provide operational oversight and day‑to‑day leadership of the entire department including technical coding (inpatient & outpatient), professional coding, coding edits, coding auditing, coding education, and coding denial management functions. Establish team structure, role definitions, and workload allocation to support high‑volume, high‑complexity services. Develop and implement department policies, workflows, and operational standards aligned with federal and state regulations, payer requirements, and organizational objectives. Oversee recruitment, onboarding, and performance management for coding analysts, coding auditors, coding educators, denial coding analysts. Coding Operations – Direct and maintain daily operations for inpatient, outpatient, surgical, and professional coding ensuring accuracy, timeliness, and compliance. Oversee accurate coding of unique and complex pediatric conditions, congenital anomalies, developmental diagnoses, and high‑acuity procedures. Ensure coding methodologies adhere to coding guidelines (including pediatric‑specific), payer rules, and Children’s Hospital Association (CHA) best practices. Explore new methods to improve coding operations and work with various constituencies to gain acceptance and support implementation efforts. Communicate operational issues and progress toward goals to Director and others as appropriate. Audits and Coding – Develop and direct the organizational annual coding audit program, including internal audits, external audit response, and corrective action plans. Oversee routine retrospective and prospective professional and technical billing audits, specialized and focused audits, and other audits as directed by the Director. Oversee preparation of written reports of audit findings and recommendations to hospital leadership and staff as appropriate. Conduct risk assessments to define audit priorities by evaluating previous audit findings, management priorities, ICD and CPT code utilization patterns, national normative data, CMS and Medicaid initiatives, and healthcare industry best practices. Maintain knowledge of current government and third‑party payor coding and documentation requirements. Collaborate with Compliance and Internal Audit teams to address identified risks and support regulatory readiness. Analyze process improvement opportunities for auditing and coding teams to identify denial risks mid‑cycle. Triage and assist in management of requests that come from Revenue Cycle teams related to coding questions on coding guidelines and denials, escalating as needed, and conducting appropriate research. Coding Education and Staff Development – Provide direction related to all activities related to the training programs, including curriculum development, job aids, testing methodology, software and delivery, exam development / delivery, employee competency metrics, certifications and development needs. Research coding guidelines when conflicts arise within current policies and procedures. Research updated coding information as it becomes available annually and mid‑year; summarize and share changes impacting Revenue Integrity staff members. Develop and implement systems to monitor performance and quality of audits and educational materials. Develop and provide educational programs and coaching for auditors, denials analysts, and educators. Ensure staff maintain required certifications and stay current with industry changes. Coding Denial Management – Lead the coding denials management strategy, working closely with denials, CDI, and revenue integrity teams to reduce preventable coding‑related denials. Oversee analysis of denial trends, identify root causes, and implement corrective measures to protect revenue. Support accurate charge capture and documentation integrity initiatives. Cross‑Functional Collaboration – Partner with clinical documentation improvement (CDI), billing, compliance, finance, and IT to optimize workflows, documentation quality, and system functionality. Participate in system upgrades, EMR enhancements, and coding‑related software implementations. Serve as a subject‑matter expert to internal stakeholders on coding regulations, best practices, and emerging trends. Reporting and Performance Monitoring – Develop and maintain dashboards and KPIs related to coding productivity, accuracy, audit results, turnaround time, and denial performance. Provide executive‑level reporting incorporating case mix, acuity, and subspecialty complexities of a children’s hospital. Monitor financial and operational impacts of coding initiatives and ensure alignment with organizational goals. Teamwork / Communication Performance Improvement / Problem‑solving Cost Management / Financial Responsibility Safety Position Status : R (Regular) – FT – Full‑Time Shift : Day Work Schedule : M‑F
Job Description
Senior Manager Coding Audits & Education – 250003C0 – will work under the direction of the Director of Health Information Management, Coding and Audit to provide strategic and operational leadership for all organizational coding functions, including hospital technical coding (inpatient and outpatient), professional coding, coding quality audits, coding education, and coding denial management. This role ensures accurate, compliant, and timely coding to support optimal revenue cycle performance and high‑quality data reporting. The Senior Manager oversees a multidisciplinary coding team, drives performance improvement initiatives, and partners closely with clinical, revenue cycle, compliance, and financial leadership. The Senior Manager will be responsible for operational success and will assist the Director to define strategy and direction in accordance with national standards and CNH policies and procedures.
Qualifications
Minimum Education
- Bachelor’s Degree in Business Administration, Health Administration, Health Information Management, Finance, or related field (Required)
- Master’s Degree in Business Administration, Health Administration, Health Information Management, Finance, or related field (Preferred)
Minimum Work Experience
Required Skills / Knowledge
Required Licenses and Certifications
Functional Accountabilities
Organizational Accountabilities
Primary Location
Maryland – Silver Spring
Work Locations
Dorchester 12200 Plum Orchard Dr Silver Spring 20904
Job Details
Full‑Time Salary Range
103,355.20 – 172,244.80
Children’s National Hospital is an equal opportunity employer that evaluates qualified applicants without regard to race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender, identity, or other characteristics protected by law. The “Know Your Rights” poster is available here : and the pay transparency policy is available here : Know Your Rights Pay Transparency Nondiscrimination Poster.
Please note that it is the policy of Children’s National Hospital to ensure a “drug‑free” work environment : a workplace free from the illegal use, possession or distribution of controlled substances (as defined in the Controlled Substances Act), or the misuse of legal substances by all staff (management, employees and contractors). Though recreational and medical marijuana are now legal in the District of Columbia, Children’s National and its affiliates maintain the right, in accordance with our policy, to enforce a drug‑free workplace, including prohibiting recreational or prescribed marijuana.
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