Manager, Medical Billing & Coding (Livermore)

Our Fortune 500 client is seeking a Manager of Medical Billing & Coding. In this newly created role, you will lead the strategy, operations, and compliance of medical billing and coding functions. This role ensures accurate, timely, and compliant billing practices, with a focus on optimizing revenue cycle performance, enhancing payer-provider alignment, and supporting patient satisfaction. The ideal candidate brings deep expertise in healthcare billing, coding standards (ICD-10, CPT, HCPCS), and payer regulations, along with strong leadership and cross-functional collaboration skills.You will:Assure compliance with ICD-10-CM/PCS and CPT-4 rules and guidelines and implement CMS and Correct Coding Initiative Guidelines (CCI) while identifying areas of potential coding, billing and documentation deficiencies and potential compliance riskSupport commercial and IT teams with coding guidance and change management processes.Request, review and code medical services from reports and notes to convert procedural and diagnostic notes into appropriate levels of care following coding rules and regulations.Demonstrate the ability to understand CMS NCD and LCD guidelines to support coding decision making Identify clinical documentation deficiencies and recommend methods for resolution that satisfy regulatory and compliance requirements.Demonstrate strong knowledge of coding software and databases.Verify that charges contain the necessary charge elements on EMR and Salesforce.Ensure all charges are entered correctly and accounted for and be able to perform charge entry and all other charge related procedures.Provide timely and accurate answers to inquiries presented by customers about clinical coding issues.REQUIRED QUALIFICATIONS Minimum 7 years experience in Revenue Cycle Management including medical billing, change entry and codingHold active coding certificationPREFERRED QUALIFICATIONSBachelors degree in healthcare administration, business, or related fieldCertified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification required.Strong knowledge of healthcare reimbursement, payer policies, and regulatory compliance.Experience with electronic health records (EHR), billing software, and revenue cycle management tools.Excellent communication, analytical, and problem-solving skills.

Created: 2025-09-24