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Coding Compliance Manager Jobs in Michigan (NOW HIRING)

Trinityhealth

IP Coding Coordinator, Remote

Livonia, MI · Remote

Provides a high-level of technical competency and serves as a subject matter expert regarding documentation, coding, billing, reimbursement and compliance management as it relates to coding. Assists ...

Healthrise

Coding Manager/Supervisor

Farmington, MI · On-site

This position offers the opportunity to guide high-performing teams while driving quality, compliance, and efficiency across coding operations. The Coding Manager is responsible for leading and ...

Healthrise

Manager, Coding Denials

Farmington, MI · On-site

Ensures team compliance with coding guidelines, payer requirements, and regulatory standards ... Ability to manage multiple priorities and competing deadlines in a fast-paced environment.

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Coding Compliance Manager information

What are some common challenges a Coding Compliance Manager faces when implementing new coding guidelines within a healthcare organization?

One common challenge for Coding Compliance Managers is ensuring consistent understanding and adoption of new coding guidelines among diverse coding staff. Differences in experience levels and interpretations can lead to discrepancies, so frequent training and clear documentation are crucial. Additionally, balancing the need for accuracy with productivity targets can be difficult, especially when guidelines change frequently. Effective communication across departments and ongoing audits help address these challenges and promote compliance.

What are Coding Compliance Managers?

Coding Compliance Managers are professionals responsible for ensuring that healthcare organizations accurately assign medical codes to diagnoses and procedures, and that these codes comply with federal regulations and payer requirements. They oversee coding staff, develop policies, conduct audits, and provide education to ensure proper billing and minimize risks of fraud or non-compliance. Their role is critical for optimizing reimbursement and maintaining the integrity of patient records.

What is the difference between Coding Compliance Manager vs Medical Coder?

AspectCoding Compliance ManagerMedical Coder
CertificationsAHIMA/AAPC certifications, compliance trainingCertified Professional Coder (CPC), CCS
Work EnvironmentHealthcare facilities, compliance departmentsHospitals, clinics, physician offices
Primary FocusEnsuring coding compliance, auditing, policy developmentAssigning medical codes for billing and documentation

The Coding Compliance Manager oversees coding practices to ensure regulatory adherence, while the Medical Coder focuses on accurately translating medical records into codes. Both roles require coding certifications, but the Compliance Manager emphasizes policy, audits, and compliance management, whereas the Medical Coder concentrates on coding accuracy for billing purposes.

What are the key skills and qualifications needed to thrive as a Coding Compliance Manager, and why are they important?

To thrive as a Coding Compliance Manager, you need deep knowledge of medical coding standards (ICD-10, CPT, HCPCS), healthcare regulations, and typically a credential such as CPC, CCS, or RHIA. Familiarity with auditing software, EHR systems, and compliance management tools is crucial. Strong analytical thinking, attention to detail, and effective communication skills set high performers apart. These competencies ensure accurate coding, regulatory compliance, and reduced risk of financial penalties for healthcare organizations.
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What job categories do people searching Coding Compliance Manager jobs in Michigan look for? The top searched job categories for Coding Compliance Manager jobs in Michigan are:
Coding Compliance Manager jobs near you
Medical Coding & Compliance Specialist

Medical Coding & Compliance Specialist

MMS

Grand Rapids, MI • On-site

$26 - $32/hr

Full-time

Posted 2 days ago

New

Job description

Description:

Position Summary


Audits medical records to verify coding of ICD or CPT codes following industry-standard coding guidelines. Reviews insurance payment and billing denial data to identify and recommend coding practice changes. Utilizes advanced knowledge of medical coding to review patient medical records, ensuring that documentation by providers conforms to legal and procedural requirements. Assigns specified codes to medical diagnoses and/or clinical procedures.


Essential Duties and Responsibilities


The essential functions include, but are not limited to the following:

  • Represent Medical Management Specialists (MMS) in the most positive and professional manner with clients, customers, guests, and the community.
  • Uphold the MMS Mission Statement: “Medical Management Specialists is committed to making a difference by providing excellent service to our clients, an outstanding work environment for our team members, and service to the community."
  • Handle confidential information and protected health information (PHI) with tact and discretion as outlined in the Employee Handbook in compliance with the Health Insurance Portability and Protection Act (HIPPA).
  • Reviews and interprets patient medical records within the MMS organization in order to determine the amount and nature of billable services.
  • Utilizes advanced, specialized knowledge of medical coding to determine the correct codes billed and appropriate sequencing in compliance with third party payer requirements.
  • Maintains up-to-date knowledge of coding and documentation requirements and offers guidance and interpretation.
  • Documents audit findings with details on appropriate coding guideline references and error rates.
  • Collaborates with leadership and colleagues regarding implementation of new codes and revision of charge documents.
  • Performs other duties as requested or assigned by leadership.
Requirements:

Minimum Qualifications (Knowledge, Skills, and Abilities)

  • Knowledge of reading, writing, mathematical and computer skills as normally acquired through completion of high school.
  • Familiarity with using Microsoft O365 Apps and has the capacity to learn to use additional software as needed.
  • Knowledge of professional coding, including but not limited to Emergency Department, Urgent Care, Observation, Anesthesia, Gastroenterology and Toxicology.
  • Knowledge of Medical Terminology, ICD-9, ICD-10, and CPT-4 coding.
  • Knowledge of anatomy and physiology.
  • Required CPC Certification.
  • Preferred 3+ years of experience in ED and UC medical coding.

Location

The job location for this position has the flexibility to become a hybrid/primarily remote position once the training period has been completed and the employee is able to maintain performance at the expected levels. Upon hire, the employee will be expected to work in office Monday - Friday for up to 90 days to complete all required training and onboarding functions. Candidate must maintain a permanent residence in the state of Michigan to be employed with this organization.


The company is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.



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About M. M. S.

Sourced by ZipRecruiter

Industry

Pharmaceutical and medicine manufacturing

Company size

1 - 10 Employees

Headquarters location

Los Angeles, CA, US

Year founded

1980

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