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Exer Medical Corporation

Coding Compliance Manager

Job Description

Coding Compliance Manager Exer Medical Corporation El Segundo, CA Job Details Full-time $90,000
  • $120,000 a year 1 hour ago Qualifications Program design CMS Regulatory compliance Medical coding experience in physician offices Medical coding experience in outpatient clinics CMS regulatory compliance Clinical staff training Retrospective medical coding audits Clinical training Content development Clinical documentation Healthcare team management Educational program planning Developing training programs for medical billing and coding teams Centers for Medicare & Medicaid Services (CMS) billing regulations Clinical documentation improvement Clinical documentation standards Healthcare claims compliance audits Managing medical billing & coding team teams Medical claim denial management Medical record review for billing accuracy Full Job Description
JOB TITLE
CODING
COMPLIANCE MANAGER
(& PROVIDER
EDUCATION
)
REPORTS TO
DIRECTOR
OF REVENUE CYLCLE MANAGEMENT
(DIRECTOR RCM)
LOCATION
HYBRID REMOTE (Must be able to travel to El Segundo Home Office and Clinic Locations)
KEY RESPONSIBILITIES
Provider Coding Education Design, standardize, and manage a Provider Coding Education program for all new and existing physicians and advanced practice providers (NPs/PAs), including structured onboarding curriculum and ongoing/refresher education. Develop role-specific training content (E/M leveling, documentation requirements, modifier usage, urgent care-specific coding scenarios) and deliver it via live sessions, recorded modules, and job aids. Track education completion, coding accuracy trends by provider, and program effectiveness; report results to Clinical and RCM leadership. Coding & Clinical Documentation Audit Program Develop, standardize, and manage a Coding and Clinical Documentation audit program covering both regular (scheduled/routine) and ad hoc audits. Build and maintain a risk-based annual audit plan and sampling methodology, informed by payer risk areas, denial trends, and OIG/CMS guidance. Manage coding auditors who execute the audit program; review findings for quality and consistency before they go to providers or leadership. Meet directly with Clinical Leaders and individual providers to deliver audit feedback, and address training, workflow, or documentation deficiencies identified through audits. Own corrective action plans for providers or coders with recurring accuracy issues, including escalation paths in partnership with Clinical Leadership and HR as needed. Coding & Documentation Standards Establish and document coding and clinical documentation best practices, workflows, and policies in conjunction with Clinical Leaders. Monitor regulatory and payer guideline changes (CMS, AMA CPT, ICD-10-CM, California Medi-Cal, and commercial payer policies) and translate updates into provider
  • and coder-facing guidance.
Partner with EMR/technology teams on templates, smart phrases, and clinical documentation tools that support accurate, compliant coding at the point of care. Coding Operations & Team Management Directly manage the production coding team, including domestic Certified Professional Coders and offshore Task Force CPCs, ensuring productivity and quality standards are met per internal and vendor SLAs. Set and monitor coding quality/accuracy benchmarks, productivity targets, and quality assurance workflows for the coding team. Support recruiting, onboarding, and ongoing development of direct reports. Revenue Cycle Partnership Partner with the RCM Manager and Director to review and address coding-related denials and underpayments, identifying root causes and durable fixes (documentation, coding, or system-based). Partner with organization leadership to evaluate new technologies (e.g., computer-assisted coding, AI-driven documentation or coding tools) and resources that support clinician documentation and coding workflows. Assist in configuring coding edits and claim-scrubbing rules within RCM systems to support clean claim submission and reduce front-end denials. Support provider education and EMR workflow training related to MIPS-related quality and documentation requirements. Support responses to payer coding audits, RADV requests, and other external chart review requests as needed.
QUALIFICATIONS
Required Experience & Education Bachelor's degree in Health Information Management, Healthcare Administration, or a related field, or equivalent combination of education and experience. 7+ years of progressive experience in professional-fee/outpatient coding, auditing, and compliance; urgent care, emergency medicine, or multi-specialty outpatient experience strongly preferred. 3+ years of experience directly managing coding staff and/or coding auditors. Demonstrated experience designing and delivering coding education programs directly to physicians and advanced practice providers. Deep working knowledge of
CPT, ICD-10-CM, HCPCS
Level II, E/M documentation guidelines, and CMS/payer documentation requirements. Experience partnering with clinical leadership to resolve documentation and coding issues, and driving provider behavior change. Experience analyzing coding-related denials and underpayments and translating findings into process or education fixes. Required or Preferred Certifications (must hold at least one; multiple strongly preferred) Certified Professional Coder (CPC)
  • AAPC Certified Professional Medical Auditor (CPMA)
  • AAPC Certified Outpatient Coder (COC)
  • AAPC Certified Documentation Expert Outpatient (CDEO)
  • AAPC Preferred Experience Prior experience in urgent care, emergency medicine, or high-volume outpatient episodic care coding.
Experience managing or partnering with an offshore/outsourced coding team. Familiarity with
MIPS/MACRA
quality reporting workflows within an EMR. Experience supporting a revenue cycle system implementation or conversion (Enter Health experience a plus). Project management experience or certification (e.g., PMP, CAPM). Other Requirements Must reside in California Comfortable working hybrid remote, with occasional travel to Southern California clinics and corporate meetings.
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Total Score
79
out of 100
Average of individual scores