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Healthfirst Coding Manager - Provider Education in New York, New York


Position Summary:

The Coding Manager- Provider Education is responsible for overseeing the Provider Coding Educators, as they educate providers on the proper use of ICD10 CM coding.Ensure that the Provider Coding Educators follow CMS and ICD10 CM guidelines to substantiate the Risk Adjustment and HCCs that are reported by providers.

Responsible for the analysis of complex data to audit provider’s clinical documentation encounters to validate Risk Adjustment and HCCs. Trend audit’s results to ensure the best education program is implemented.

Responsible for managing the team as they respond to provider’s inquiries via the coding hotline as well. Work together with the Manager of Coding Compliance & HCC Projects to improve coding accuracy and productivity of all the coders within the department.


  • Subject matter experts for proper risk adjustment coding and CMS data validation

  • Responsible to train coding educators and clinical providers on coding guidelines, ensuring compliance around clinical documentation accuracy and ICD10 CM rules

  • Develop relationships with clinical providers and communicate coding and documentation guidelines and requirements of the Risk Adjustment program to ensure correct coding and documentation

  • Analyze data to prioritize provider educational reviews

  • Creates presentations, develops learning materials, handbooks, and other training materials.

  • Compile data and present solutions regarding trends or patterns noticed in provider coding

  • Manage coding educators to ensure the minimum number of coding quality reviews are consistent with established departmental goals

  • Timely and completely executes coding and other departmental projects aimed to mitigate risk and improve compliance and quality with effective time and project management, delegation, and critical thinking skills.

  • Supervises, evaluates, and coordinates daily team operations and responsibilities to ensure that departmental productivity goals are met in regards to quality, timeliness, accuracy, and consistency.

  • Develops and monitors team goals; provides ongoing feedback and coaching; conducts annual performance reviews; leads by example; and ensures an atmosphere of open communication, teamwork, and empowerment to make informed decisions.

  • Using AMA Coding guidelines, CMS coding regulations, ICD10 coding rules, coding clinics and coding industry standards to implement education targeted to providers who have documentation and coding deficiencies.

  • Creation of PowerPoint presentations for department meetings and provider education.

  • Responsible to follow CDI (Clinical Documentation Improvement) guidelines and supervise the CDI application by the coding educators.

  • Responsible to train Coding Educators on the creation of PDF Job Aids to describe coding rules for all specialties.

  • Helps with the creation and approval of coding content for publishing on the provider portal.

  • Additional duties as assigned.

  • Bachelor’s Degree Preferred

  • High School diploma or GED.

  • Certified Coding Profession certification: (CPC), CRC and CDEO

  • Optional Certified Coding Profession certification: CPMA

  • Preferred five years’ experience coding education in a hospital, physician, or insurance environment

  • Preferred five years’ experience coding SOAP notes for different specialties

  • Preferred five years’ experience coding in a hospital, physician, or insurance environment

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

If you have a disability under the Americans with Disability Act or a similar law, and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

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