Manager PB Coding Denials Integrity - Medical Specialties

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Manager PB Coding Denials Integrity - Medical Specialties based in United States. This is a full-time leadership role focused on professional billing coding denials, revenue cycle integrity, and operational performance across multiple medical specialties. You’ll oversee daily operations while improving processes, standardizing workflows, and strengthening financial and operational outcomes. The role supports a broad range of specialties, including laboratory, pathology, behavioral health, pediatrics, dermatology, gastroenterology, endocrinology, nephrology, rheumatology, pulmonology, OB/GYN, and urology. You’ll use data, healthcare technology, and performance indicators to identify trends, address operational gaps, and drive measurable improvements. The position combines team leadership with cross-functional collaboration across clinical, IT, compliance, finance, and revenue cycle teams. You’ll also help ensure coding and revenue cycle practices remain aligned with regulatory requirements, reimbursement rules, and organizational standards. This opportunity is well suited to an experienced healthcare revenue cycle leader who enjoys developing teams and improving complex, highly regulated operations. Accountabilities: - Lead and manage daily operations within the assigned professional billing coding denials and integrity function, ensuring activities align with broader organizational and revenue cycle objectives. - Evaluate workflows and operational processes to improve efficiency, productivity, consistency, and adoption of standardized best practices across the mid-revenue cycle. - Monitor compliance with regulatory requirements, accreditation standards, coding guidelines, and organizational policies while protecting the confidentiality of patient information and escalating potential compliance concerns appropriately.

- Establish and monitor key performance indicators (KPIs), analyze operational trends, and use data-driven insights to identify opportunities for improvement. - Leverage healthcare technology, electronic health record systems, analytics tools, and revenue cycle solutions to improve decision-making and operational performance. - Partner with clinical, IT, Compliance, Finance, and Revenue Cycle leaders to align processes, resolve issues, support regulatory compliance, and advance patient safety and financial integrity. - Build and maintain effective relationships with key stakeholders across a matrixed organization, facilitating communication, problem-solving, and operational alignment. - Lead and develop a team of professionals, including hiring, performance management, coaching, training, professional development, and career growth activities. - Foster a culture of accountability, continuous improvement, collaboration, and financial responsibility across the team. - Lead strategic operational initiatives, manage project timelines, and oversee system or workflow enhancements designed to improve effectiveness and scalability. - Support the medical specialties portfolio across areas including laboratory, pathology, behavioral health, pediatrics, allergy and immunology, dermatology, gastroenterology, hepatology, infectious disease, endocrinology, nephrology, rheumatology, pulmonology, sleep medicine, maternal-fetal medicine, OB/GYN, reproductive endocrinology, and urogynecology. Requirements: - Bachelor’s degree in Health Information Management, Healthcare Administration, or a related field, or equivalent professional experience. - At least 8 years of experience in mid-revenue cycle operations, coding, Health Information Management (HIM), healthcare technology, or a related area, including 2+ years of leadership experience within a large integrated healthcare system. - Current relevant industry certification from an approved accrediting body is required.