HIM Coding Manager Auditing and Education - HIM Financial - Full Time 8 Hour Days (Exempt) (Non[...]

The Manager, HIM Coding Auditing and Education provides leadership and operational oversight for the inpatient and outpatient coding audit and education programs. The role ensures coding accuracy, regulatory compliance, and continuous improvement in coding quality across the organization. Responsibilities Audit Program Leadership: Manage the IP & OP coding audit programs and teams; oversee timely completion of audits and adherence to quality standards. Direct the review and analysis of audit findings, identify coding trends and risk areas, and implement corrective action plans to improve accuracy and reduce compliance risk. Develop, implement, and maintain coding audit strategies aligned with CMS, OIG, and internal compliance standards. Lead staff education, coaching, and performance management for coding auditors and coding staff. Collaborate with Coding Leadership, CDI, Compliance, Revenue Integrity, and Patient Financial Services to address coding and documentation issues. Participate in recruitment, hiring, onboarding, and training of coding auditors. Prepare executive‑level audit reports and present findings to compliance and revenue cycle leadership. Coordinate with Compliance leadership to respond to internal and external audit results. Provide strategic oversight of inpatient and outpatient coding education programs. Direct development and maintenance of orientation, training, and educational materials. Serve as subject matter expert on official coding guidelines and regulatory requirements. Direct delivery of group and individual coding education sessions. Monitor changes to coding methodologies and regulatory updates and ensure timely staff education. Analyze coding and documentation impacts on reimbursement and identify improvement opportunities. Oversee the Coding Editor program and manage post‑coding pre‑bill edits, denial prevention strategies, and medical necessity documentation issues. Manage denials triage, resolution, and appeals management, including preparation of rebuttal letters and appeal packages for Medicare, Medi‑Cal, MACs, RACs, QIOs, and commercial payers. Maintain advanced knowledge of legal, regulatory, and policy requirements related to coding and documentation. Direct regulatory and coding research activities using authoritative resources. Lead root cause analysis activities to identify systemic coding, documentation, and workflow issues. Support documentation improvement initiatives with CDI leadership. Oversee development and maintenance of reports monitoring audit activity, denials, appeal outcomes, and coding accuracy. Provide actionable recommendations to leadership to improve coding accuracy and reduce denials. Serve as primary liaison among Coding, CDI, Compliance, Revenue Integrity, and Patient Financial Services and external payers. Communicate coding audit findings, compliance risks, and improvement opportunities to leadership and stakeholders. Oversee use of coding audit and education systems and promote effective use of EHR and coding tools. Qualifications Required Education: Bachelor’s Degree in Health Information Management (HIM), Health Information Technology (HIT), or Health Information Systems (HIS). Required Training: Successful completion of college courses in Medical Terminology, Anatomy & Physiology, and a coding certification course. In‑depth knowledge of ICD‑10‑CM, ICD‑10‑PCS, MS‑DRG, APR‑DRG, CPT, and HCPCS coding principles. At least 10 years experience in ICD‑10 coding of inpatient and outpatient records in an acute care setting. At least 2 years of leadership experience. Experience using computerized coding and abstracting databases (e.g., 3M 360 Encompass/CAC, 3M CRS). Advanced knowledge of coding compliance and regulatory requirements, CMS coding and billing rules. Strong analytical, problem‑solving, and organizational skills. Excellent written and verbal communication, presentation, and training abilities. Must be able to work independently and collaboratively. Certified Coding Specialist – CCS (AHIMA) or AACC Inpatient Coder – CIC (AAPC) required, or one of these credentials with an additional national HIM credential (RHIT or RHIA). Passing score of ≥90% on the hospital‑specific coding test (waived for >10 years of experienced inpatient coding). Fire Life Safety Training (Los Angeles) required; certification must be obtained within 30 days of hire and renewed as required. Preferred Qualifications Experience in denial prevention strategies and post‑coding pre‑bill edits. Knowledge of OCE/NCCI edits, CMS and MAC guidance, and payer policies. Strong presentation and training skills. Compensation The annual base salary range for this position is $110,240.00 - $181,896.00. EEO Statement USC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other characteristic protected by law or USC policy. USC observes affirmative action obligations consistent with state and federal law. #J-18808-Ljbffr University of Southern California