Note: The job is a remote job and is open to candidates in USA. nimble solutions provides revenue cycle management solutions for surgical organizations. The Coding Quality and Education Manager supports coding quality, compliance, and education through audits, trend analysis, targeted training, and collaboration with internal teams and external clients.
Responsibilities
- Perform prospective and retrospective audits of outpatient and professional surgical coding, including CPT, ICD-10-CM, modifier assignment, and compliance with Official Coding Guidelines, NCCI/OCE edits, and payer policies
- Support and maintain the coding quality assurance program, including audit methodologies, scoring, documentation standards, and quality tracking processes
- Analyze audit results and quality trends to identify risk areas, educational needs, and opportunities for process improvement
- Develop and deliver targeted coder- and provider-facing education, including remediation, training sessions, and client-specific education as needed
- Prepare client-facing audit summaries and reports that communicate quality scores, trends, and recommended actions clearly and professionally
- Collaborate with Coding Operations and cross-functional teams to support workflow optimization, standardization of best practices, and achievement of quality and service-level expectations
- Provide expert-level support for complex coding questions across Ambulatory Surgery Centers and Professional Fee services
- Participate in quality and compliance initiatives, including follow-up audits, monitoring of corrective actions, and validation of improvement outcomes
- Contribute to special projects related to audits, quality improvement, workflow enhancements, client onboarding, and ongoing client support
Skills
- 8–10+ years of coding experience, including outpatient and/or professional surgical coding
- 5+ years of coding quality auditing and/or coding education experience
- Advanced knowledge of CPT, ICD-10-CM, modifier usage, Medicare regulations, OPPS, and payer policies
- Experience with surgical specialties such as orthopedics, spine, pain management, ophthalmology, and general surgery
- Strong written and verbal communication skills, including client-facing education and presentation capabilities
- Excellent analytical skills with the ability to interpret audit data and translate findings into actionable education
- Highly organized with the ability to manage multiple priorities and meet deadlines in a fast-paced, remote environment
- Self-directed, solution-oriented mindset with strong critical thinking and problem-solving abilities
- Proficiency in Microsoft Excel, Word, PowerPoint, and SharePoint
Benefits
- Remote work arrangement
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