Children's National Hospital · 5 days ago
Senior Manager Coding Audits & Education
Silver Spring, MD
Full-time
Onsite
Mid, Senior Level
$103K/yr - $103K/yr
7+ years expChildren's National Hospital is seeking a Senior Manager for Coding Audits & Education to provide strategic and operational leadership for all organizational coding functions. This role involves overseeing a multidisciplinary coding team, ensuring accurate and compliant coding, and driving performance improvement initiatives to support optimal revenue cycle performance.
AssociationChild CareHealth CareNon Profit
Responsibilities
Contribute to the strategic plan for department services, including short-term and long-term objectives
Collect and analyze customer and stakeholder feedback to evaluate department effectiveness and incorporate findings into plans to modify program and external communication
Work with the Director, Vice President and other involved 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
Provide operational oversight and day-to-day leadership of 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
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 towards goals to Director and others as appropriate
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 other 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
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/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
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
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
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
Qualification
Required
Bachelor's Degree Business Administrative, Health Administration, Health Information Management, Finance, or related field (Required)
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
3M, Epic and/or Cerner Millenium
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
Certified Coding Specialist (CCS) Upon Hire (Required) Or Similar Medical Coding Certification(s) - CIC and/or CPC
Preferred
Master's Degree Business Administrative, Health Administration, Health Information Management, Finance, or related field (Preferred)
Familiarity with population health strategies, alternative payment models, and care coordination strategies preferred
Company
Children's National Hospital
Children’s National Hospital, based in Washington, D.C., was established in 1870 to help every child grow up stronger.
Founded in 1870Washington, District of Columbia, USA
5001-10000 employees
H1B Sponsorship
Children's National Hospital has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (82)
2024 (55)
2023 (92)
2022 (59)
2021 (41)
2020 (51)
Funding
Current Stage
Late StageTotal Funding
$19.4MKey Investors
Gilbert Family FoundationAdvanced Research Projects Agency for HealthUnited Health Foundation
2025-10-09Grant· $8M
2024-10-23Grant· $8M
2021-11-09Grant· $3.4M
Leadership Team
Kurt Newman
President and CEO
Michelle Riley-Brown, MHA, FACHE
President and CEO
Recent News
BioWorld Financial Watch
2025-06-07
Company data provided by crunchbase