HIM Coding Manager for AI Evaluation

Lead and validate professional fee and/or inpatient facility medical coding operations while evaluating and annotating AI-generated coding outputs to train next-generation autonomous coding systems. This role combines hands-on coding leadership with systematic review of AI-assigned ICD-10-CM/PCS, CPT/HCPCS, and DRG results to improve coding accuracy, productivity, and compliance across healthcare settings.

• Oversee profee and/or facility inpatient coding operations, maintaining accuracy, productivity, and compliance with coding guidelines.
• Evaluate AI-generated coding assignments, including ICD-10-CM/PCS diagnoses and procedure codes, CPT/HCPCS codes, and DRG assignments, for accuracy and regulatory compliance.
• Conduct coding quality audits and deliver targeted feedback to coding staff and to AI systems.
• Monitor and report coding KPIs, including coder productivity, accuracy rates, unbilled accounts, and claim denial rates attributable to coding errors.
• Manage coding workflow queues, work distribution, and turnaround time compliance.
• Ensure adherence to Official Coding Guidelines, CMS regulations, and payer-specific coding requirements.
• Provide ongoing coding education and compliance training to coding staff.
• Collaborate with clinical documentation improvement, billing, and compliance teams to resolve coding-related revenue integrity issues.
• Annotate AI-generated coding outputs and provide structured, consistent feedback to build and refine AI training datasets.

• Minimum 5 years of medical coding experience, with at least 2 years in a coding manager or HIM leadership role.
• Expert knowledge of ICD-10-CM/PCS, CPT/HCPCS, and Official Coding Guidelines.
• Proficiency in professional fee (profee) coding and/or facility inpatient coding, including DRG assignment experience.
• Experience performing coding audits and designing coding quality improvement programs.
• Familiarity with coding software such as 3M, Nuance, Optum360, TruCode, and common EHR platforms.
• Exceptional written and verbal English communication skills.
• High attention to detail, with ability to identify coding errors, compliance risks, and inaccuracies in AI outputs.

• CPC, CCS, RHIA, or RHIT credential.
• Experience with computer-assisted coding tools and NLP-based coding platforms.
• Background in inpatient facility coding with DRG optimization experience.
• Prior experience evaluating AI-generated coding assignments or working with AI coding tools.
• Experience presenting coding performance data and quality metrics to leadership.

• Location: Remote.
• Employment type: Hourly.

• Pay rate listed as 80 - 80 hourly, equivalent to $80 per hour.

• Remote role, applicants must be able to perform work remotely under the listed hourly terms.