Manager, Physician Revenue Cycle Coding

Whatever the role, everyone at Grady is part of something bigger. Choosing a career at Grady is choosing to be part of a legacy of service and commitment to our communities. If you want to make a difference, we want to hear from you.

Job Summary

Position will work closely with the Director of Revenue Cycle Coding and Operations to provide training and education for coding. Leading research and analyses in charge review, claims edit, and coding work queues. Manages the work of staff who review, interpret, code and abstract medical records information according to standard classification systems. Ensures optimum reimbursement for Physician services through accurate and timely coding of all inpatient and outpatient services for employed Physicians. Reviews coding and data quality reviews and prepares complex reports as required. Supervisory responsibilities for assigning, directing, monitoring and evaluating the work of subordinate staff on a regular basis, as well as performing the most technically difficult coding and abstracting duties in the department. Ensures all Revenue Cycle coding activities comply with Physician billing standards and government regulation with concentration on hospital inpatient procedures and specialty physician services. Ensures compliance with internal policies and procedures and governing agencies. Works with managers to assist with departmental needs and planning, including developing policies and procedures to facilitate timely and accurate reimbursement.

Responsible for all CBO charge capture and reconciliation functions are accurate and reimbursement/collection impacts are identified via charge capture process. Produces reporting as well as providing reimbursement opportunities to Revenue Cycle leadership and other stakeholders at all levels of the organization. Maintains close working relationship with physicians and clinic administration to improve charge capture opportunities and reconcile charges. Will serve as the subject matter expert on content of Epic Charge Capture and Reconciliation functionality related to reporting and charge entry, e.g., Epic Professional Billing.

JOB REQUIREMENTS

• Manages the Outpatient, Inpatient, and Physician professional fee coding to ensure compliance to ONE GRADY policies and procedures.

• Oversees, directs, and guides coding specialists. Responsible and accountable for coding accuracy, timeliness, editing, and utilization of systems and tools used to perform coding functions.

• Oversees, directs, and guides analyst that performs manual charge entry and reconciliation processes for all ambulatory, procedural, ancillary, and hospital services.

• Identify coding, charge entry, or clinical documentation opportunities and works with leadership and clinical team members to make recommendations for improved charge compliance/capture, and reimbursement/collection impacts.

• Builds strong relationships and facilitate effective communication between hospital and physician-based Revenue Cycle and Clinical (where appropriate) operations.

• Proactively seek out positive or negative trends in charge/coding capture processes to facilitate sharing of best practice and/or performance improvement opportunity identification.

• Works closely with physicians to ensure that charges are being accurately and compliantly being captured, billed, and follow up on.

• Works closely with physicians to ensure that charges are being accurately and compliantly being captured, billed, and reports performance in charge capture/delays, chart closure/documentation. That provides education and guidance to clinical leadership and providers regarding errors in charge/coding submission to facilitate corrective action planning for improved charge/coding capture.

• Using data and reports, performs root cause analyses to identify areas where the process may not be working effectively or efficiently. Working with the entity, lead process improvement efforts in the entity or in corporate Revenue Cycle Operations to drive improvement in the overall revenue cycle process.

• Proactively identifies sources of issues and communicates these to the appropriate parties. In conjunction with the Entity and corporate Revenue Cycle leadership teams, maintains ongoing issues and priority list for Entity and corporate Revenue Cycle. Completes analysis of issues for action, presents this information and implements action plans as approved by the Director of Revenue Cycle.

• Analyzes Key Performance Indicator (KPI) data and coordinate Revenue Cycle analytics, utilizing all available data.

• Reviews patient medical records to recommend or assign codes and modifiers for diagnoses, treatments, surgical procedures, and non-surgical procedures for professional services.

• Assures industry accepted coding principles, government regulations, protocols, and third-party requirements pertaining to billing and documentation are followed.

• Identifies training needs for coding staff; designs, develops, schedules, and implements training activities as needs are identified.

• Conducts quality reviews to insure maintenance of industry standards of 95% accuracy for Coding and Charge Entry transactions. Identifies opportunities for efficiencies and implements as approved.

• Assists with the coordination of internal and external coding compliance audits.

• Provides written reports to Director or Manager with audit results. Provides accurate and appropriate answers to physician's coding and billing questions on a timely basis.

• Ensures maximum efficiency and reimbursement for properly documented services.

• Reviews, modifies, and recommends changes to policies and procedures to improve professional fee coding and data management.

• Aligns knowledge of coding and documentation requirements, working closely with Revenue Cycle Departments.

• Additional duties as assigned

EDUCATION :

BA in Health Administration

CERTIFICATION:

CPC, CCS, CPC-H, CCS-P, CCS-H, RHIA, RHIT, or equivalent coding certification

Core Competencies
These competencies reflect the values and behaviors expected of all Grady team members, regardless of role. They ensure that every employee contributes to safe, high-quality care, positive patient experience, and a collaborative work environment.

1. Patient-Centered Care - Demonstrates a commitment to delivering safe, compassionate, and high-quality care that prioritizes the well-being and satisfaction of patients and their families.
2.Integrity & Accountability - Acts ethically, maintains confidentiality, and accepts responsibility for actions, decisions, and outcomes.
3.Collaboration & Teamwork - Builds positive relationships, works effectively across departments, and supports colleagues to achieve shared goals.
4. Communication - Communicates clearly, respectfully, and effectively with patients, families, colleagues, and leadership.
5.Respect & Inclusion - Creates an inclusive environment by valuing diversity, treating others with dignity, and ensuring equitable care and opportunities for all.
6. Quality & Safety - Adheres to best practices, regulatory standards, and policies to ensure safe, reliable, and high-quality outcomes.
7. Adaptability & Resilience - Responds effectively to change, remains flexible in dynamic situations, and demonstrates resilience under pressure.
8. Continuous Improvement - Seeks opportunities to improve processes, skills, and outcomes through innovation, learning, and feedback.
9. Leadership & Professionalism - Inspires, guides, and develops individuals and teams while modeling professionalism, fairness, and transparency.
10. Employee Experience Focus - Champions a supportive and engaging employee journey that enables staff to thrive and, in turn, deliver exceptional patient care.

Grady Total Rewards
At Grady, we believe in supporting the health, well-being, and growth of every team member. Our Total Rewards package is designed to provide competitive pay and comprehensive benefits that make a difference in your life and career, including:

• Health & Wellness: Medical, dental, vision, and prescription drug coverage.

• Financial Security: Retirement savings plans with employer contributions, life insurance, and disability coverage.

• Work-Life Balance: Paid time off, holidays, and family leave benefits.

• Career Growth: Tuition reimbursement, professional development programs, and opportunities for advancement.

• Employee Support: Employee Assistance Program (EAP), wellness initiatives, and discounts on services.

Grady's Total Rewards are designed to ensure our employees feel valued, supported, and empowered, both at work and beyond.

Why Join Grady?
Grady Health System is more than a hospital - we are a vital part of Atlanta and the surrounding communities. For over 125 years, Grady has been committed to providing exceptional care, advancing health equity, and making a difference in the lives of those we serve. When you join Grady, you become part of a team that values excellence, compassion, innovation, and collaboration.

Here, every role matters. Whether you provide direct patient care, support our operations, or lead teams, you play an important part in fulfilling our mission. We offer opportunities to learn, grow, and build a meaningful career in an environment where your contributions are recognized and valued.

At Grady, we don't just work, we make an impact.

Equal Opportunity Employer Statement:
Grady Health System is proud to be an equal opportunity employer. We are committed to fostering a workforce where all employees feel valued, respected, and empowered to succeed. We prohibit discrimination and harassment of any kind based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other legally protected characteristic.

Grady is dedicated to creating an accessible work environment and provides reasonable accommodations to qualified individuals with disabilities to ensure equitable opportunities for success.