Manager, Coding & Charge Entry

Department: Revenue Cycle Management (RCM)

Reports To: VP, Revenue Cycle Management Location: Remote (U.S.)

FLSA Status: Exempt

Position Summary

The Manager, Coding & Charge Entry is responsible for leading professional coding and charge entry operations utilizing AthenaOne Practice Management and EHR. This leader ensures coding accuracy, charge integrity, regulatory compliance, timely claim submission, and revenue optimization across a multi-state pain management practice with a physician-owned laboratory. This role also leads the exploration, evaluation, implementation, and ongoing optimization of AI-enabled coding technologies and automation to improve coding accuracy, productivity, compliance, and revenue cycle performance.

Minimum Qualifications

• CPC (AAPC) or CCS (AHIMA) certification required

• 5–7 years of pain management coding experience

• Prior AthenaOne experience required

• 3+ years leadership experience preferred

• Physician-owned laboratory coding experience required

• Strong knowledge of CPT, HCPCS, ICD-10-CM, NCCI, LCD/NCDs, Medicare, Medicaid, commercial payer policies, and OIG guidance

• Multi-state physician practice experience preferred

Essential Responsibilities

• Lead Coding and Charge Entry operations.

• Supervise coding and charge entry staff.

• Manage AthenaOne coding work queues and charge routing.

• Ensure accurate coding for pain management procedures, E/M services, physician-owned laboratory testing, injections, implants, fluoroscopy, ultrasound guidance, and related services.

• Oversee daily charge reconciliation, charge lag, missing encounters, edits,

modifiers, and charge release.

• Escalate provider education and clinical documentation improvement needs to supervisor.

• Conduct coding audits and quality reviews.

• Monitor payer policy updates and regulatory compliance.

• Partner with RCM leadership to improve revenue capture and documentation.

• Lead the exploration and evaluation of AI-assisted and autonomous coding solutions, including assessment of vendor capabilities, AthenaOne integration, workflow fit, compliance, and return on investment.

• Develop and execute an AI coding implementation roadmap, including pilot design,

testing, validation, change management, staff training, and phased deployment.

• Establish quality controls and human oversight for AI-generated coding recommendations to ensure accuracy, medical necessity, documentation alignment, payer compliance, and appropriate escalation.

• Monitor AI coding performance using accuracy, productivity, denial, edit, charge

lag, and financial-impact metrics; identify opportunities for continuous optimization.

• Partner with RCM leadership, Compliance, IT, clinical leadership, and external vendors to evaluate and implement coding automation while maintaining regulatory and data-security standards.

• Assess how AI and automation may reshape coding and charge entry workflows, staffing models, work queues, and productivity expectations, and recommend operational changes accordingly.

• Coordinate AthenaOne workflow optimization and work with Athena Customer

Success Managers.

Key Performance Indicators

• Coding Accuracy ≥98%

• Charge Entry Accuracy ≥99%

• Charge Lag ≤2 business days

• Coding Audit Score ≥95%

• Coding Denial Rate <3%

• Work Queue Aging <48 hours

• Daily Charge Reconciliation 100%

Leadership Competencies

Executive communication, accountability, process improvement, change management, coaching, physician collaboration, data-driven decision making, regulatory expertise, and operational excellence, AI/automation adoption, technology evaluation, and digital transformation leadership.

Equal Employment Opportunity and Accommodation

Commonwealth Pain & Spine is an equal opportunity employer and provides reasonable accommodations to qualified applicants and employees in accordance with applicable law.