Machinify

2 weeks ago

Manager, Medical Review Coding — Behavioral Health

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 11 hours agoStatus: Live

Job Summary

Own operational results for a remote outpatient behavioral health medical review coding audit team, ensuring audit quality, productivity, and team performance. Serve as the subject matter expert across behavioral health CPT coding, DSM-5-based diagnostic coding, and payer/regulatory requirements. Lead the development of audit guidelines, monitor policy changes, drive capacity and staffing planning, and partner with clinical and QA/appeals teams to implement new clients and continuous improvements.

Location: United States

Workplace: Remote

Employment Type: Full time

Job Function: Healthcare (Clinical, Medical, Wellness)

Seniority: Manager level

Key Responsibilities

•Provide operational oversight of the outpatient behavioral health coding audit team and serve as the primary behavioral health coding subject matter expert.
•Lead development, maintenance, and refinement of behavioral health review guidelines aligned with CMS, Medicaid, and commercial payer policies.
•Manage daily activities of coding audit staff, providing behavioral health guidance, coaching, and constructive feedback to drive quality and performance.
•Oversee staffing, time and attendance, performance reviews, and corrective action in collaboration with HR and senior management.
•Develop training materials and best practices; deliver operational and performance reporting to senior management and participate in client-facing meetings as needed.

Pay and Benefits

Salary: USD 130,000 - 140,000 annually

Perks:Health InsuranceDentalVision401kHsaFsaLearning Budget

Key Requirements

•Current certification as a CPC, CPC-P, RHIA, RHIT, or CCS; CPMA strongly preferred.
•5+ years of outpatient behavioral health medical coding and/or coding audit experience in a provider, payer, or payment integrity setting.
•5+ years of direct experience coding or auditing behavioral health outpatient claims (psychiatric services, SUD treatment, ABA therapy, and/or psychological testing).
•In-depth knowledge of DSM-5 diagnostic coding applied to ICD-10-CM and behavioral health documentation requirements.
•4+ years of relevant management or supervisory experience overseeing remote audit or coding teams (behavioral health specialization required).

Experience:HealthcareBehavioral healthPayment integrityCoding audits

Skills:LeadershipCoachingCommunicationAnalytical skillsIndependent work

Certifications:CPCCPC-PRHIARHITCCSCPMACBHCSCertified Behavioral Health Coding Specialist

Languages:English

Tech Stack:DSM-5ICD-10-CMCPTHCPCS Level IICMS-1500MedicaidEHR systemsMicrosoft OfficeExcel

Company Brief

Machinify

Provides AI-driven predictive maintenance and asset-monitoring solutions for manufacturing and industrial operations, using IoT sensor data and machine learning to reduce downtime, optimize performance, and extend equipment life.

Industry: Industrial Automation

Website

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Machinify

2 weeks ago

Manager, Medical Review Coding — Behavioral Health

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 11 hours agoStatus: Live

Job Summary

Location: United States

Workplace: Remote

Employment Type: Full time

Job Function: Healthcare (Clinical, Medical, Wellness)

Seniority: Manager level

Key Responsibilities

•Provide operational oversight of the outpatient behavioral health coding audit team and serve as the primary behavioral health coding subject matter expert.
•Lead development, maintenance, and refinement of behavioral health review guidelines aligned with CMS, Medicaid, and commercial payer policies.
•Manage daily activities of coding audit staff, providing behavioral health guidance, coaching, and constructive feedback to drive quality and performance.
•Oversee staffing, time and attendance, performance reviews, and corrective action in collaboration with HR and senior management.
•Develop training materials and best practices; deliver operational and performance reporting to senior management and participate in client-facing meetings as needed.

Pay and Benefits

Salary: USD 130,000 - 140,000 annually

Perks:Health InsuranceDentalVision401kHsaFsaLearning Budget

Key Requirements

•Current certification as a CPC, CPC-P, RHIA, RHIT, or CCS; CPMA strongly preferred.
•5+ years of outpatient behavioral health medical coding and/or coding audit experience in a provider, payer, or payment integrity setting.
•5+ years of direct experience coding or auditing behavioral health outpatient claims (psychiatric services, SUD treatment, ABA therapy, and/or psychological testing).
•In-depth knowledge of DSM-5 diagnostic coding applied to ICD-10-CM and behavioral health documentation requirements.
•4+ years of relevant management or supervisory experience overseeing remote audit or coding teams (behavioral health specialization required).

Experience:HealthcareBehavioral healthPayment integrityCoding audits

Skills:LeadershipCoachingCommunicationAnalytical skillsIndependent work

Certifications:CPCCPC-PRHIARHITCCSCPMACBHCSCertified Behavioral Health Coding Specialist

Languages:English

Tech Stack:DSM-5ICD-10-CMCPTHCPCS Level IICMS-1500MedicaidEHR systemsMicrosoft OfficeExcel

Company Brief

Machinify

Industry: Industrial Automation

Website