Coding Manager (Risk Adjustment)

Overview

The Coding Manager leads a team of coders, directly or indirectly, to deliver key components to the Cotiviti coding program. This role works with the Director of Coding, the Client team and other areas related to production, QA, and analytics for oversight of ongoing production and quality accuracy.

Responsibilities

Work with the Director, Coding Services to oversee CMS-HCC and HHS- HCC coding production and quality including the management of staff, hiring, promoting, evaluating, and training, disciplining, and mentoring at the client team level. Facilitates all production meetings with Reporting, Data Capacity operations planning, and leadership to develop coding and abstraction production plans. Communicates production plans, quality goals and project priorities to internal Coding teams as well as external vendor partners in preparation for on-boarding and/or scheduling of all client projects, including on and offshore coding. Resolve issues that impact coding production and the full utilization of coding abstraction services for MRA, CRA and Medicaid. This will involve working closely with chart retrieval staff, IT, Production Analytics, HR, Trainers, and the QA team. Utilize Coding forecast and coding output data to monitor coding productivity and quality; address coders work performance concerns through meeting with the Coder and/or coding vendor leadership to develop an action plan as needed regarding production and quality accuracy standards. This includes the development of monitoring tools as needed to continually assess staff progress toward goal achievement. Constructs and communicates internal system reports for all coders (Coder I, Coder II, QA I and QA II and Team Leads) in the Clinical Coding Department. These reports cross production and quality accuracy. Reports are reviewed daily, weekly, monthly, quarterly, and yearly as needed. Ensures completion of various chart types (physician, hospital outpatient, hospital inpatient) from both a production and quality accuracy perspective. Frequently meets with clients to provide meaningful updates on project progress; works closely with client success and coding quality to ensure successful deliverables. Hire, develop, coach, lead and retain top-tier talent, with a focus on building and improving a team and culture that is able to assist in employing best in class practices to support and drive high levels of internal and external customer satisfaction. Complete all responsibilities as outlined in the annual performance review and/or goal setting. Complete all special projects and other duties as assigned. Must be able to perform duties with or without reasonable accommodation. This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change.

Qualifications

Bachelor’s degree, Coding certification; RHIA, RHIT, CRC, CCS, CCS-P, CPC, CPC-H (Nationally certified medical coder as certified by either AAPC or AHIMA) or 4 years equivalent work experience. 5+ years of HCC medical coding, record abstraction experience, including supervisory experience. Ability to establish, monitor and enforce staffing schedules and production schedules. Ability to analyze data to identify trends, outliers or areas that need attention from both a production and quality perspective, and implement changes as needed. Ability to act as a coding resource or QA resource for Medicare Risk Adjustment, Commercial Risk Adjustment and Medicaid when production volume is required. Excellent written and verbal skills including coaching and interpersonal skills, and client interaction. Strong knowledge of medical terminology and anatomy and physiology. Analytical and critical thinking skills to understand data to influence decision making. Computer and technology literate. Manage multiple client deliverables and competing deadlines simultaneously. Awareness and adherence to HIPAA privacy and security regulations. Must remain flexible to provide assistance in any emergent situations and/or projects. Must be able to perform duties with or without reasonable accommodation. Work is performed in an office setting with some possible travel. Mental Requirements: Communicating with others to exchange information. Assessing the accuracy, neatness, and thoroughness of the work assigned. Physical Requirements and Working Conditions: Remaining in a stationary position, often standing or sitting for prolonged periods. Repeating motions that may include the wrists, hands, and/or fingers. Must be able to provide a dedicated, secure work area. Must be able to provide high-speed internet access/connectivity and office setup and maintenance. Base compensation ranges from $82,000 to $102,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. This role is eligible for discretionary bonus consideration. Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page. Date of posting: 6/15/2026 Applications are assessed on a rolling basis. We anticipate that the application window will close on 8/30/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected. #senior #LI-SL1 #LI-Remote Apply To This Job