Client Success- Coding Manager

About Plutus Health Inc.: Plutus Health Inc. is a leading provider of Revenue Cycle Management (RCM) services, certified in SOC2 compliance and recognized among the Inc. 5000 fastest-growing private companies. We specialize in revenue cycle optimization for hospitals, physician groups, and healthcare organizations across various specialties. Our commitment to innovation and excellence has earned us recognition as a 2024 EY Entrepreneur Of The Year finalist and one of the top 100 fastest-growing companies in Dallas. Job Description: We are seeking an experienced Client Success- Coding Manager with expertise in medical coding, auditing, and compliance to oversee client relationships, coding operations, and revenue cycle optimization. This role requires a deep understanding of CPT, ICD-10, HCPCS, payer policies, and denial management, ensuring that clients receive best-in-class coding services and compliance support. The ideal candidate will have a strong background in medical coding, compliance audits, RCM workflow optimization, and payer regulations, along with exceptional client relationship management skills. Key Responsibilities: Client Success & Relationship Management: - Serve as the primary point of contact for clients, ensuring smooth communication and resolution of coding-related concerns. - Develop and implement client engagement strategies to maximize satisfaction, retention, and revenue growth. - Conduct Quarterly Business Reviews (QBRs) and compliance audits to drive process improvements. - Identify upsell and cross-sell opportunities within client accounts to expand coding service offerings. Medical Coding & Compliance Oversight: - Ensure adherence to ICD-10, CPT, HCPCS, and payer-specific guidelines across multiple specialties. - Conduct coding audits, documentation reviews, and risk assessments to improve coding accuracy and compliance. - Monitor denial trends, coding discrepancies, and revenue leakage, implementing corrective actions as needed. - Stay up to date with Medicare, Medicaid, and commercial payer regulations, ensuring regulatory compliance. - Provide training and education to clients and internal teams on evolving coding guidelines and best practices. Revenue Cycle & Denial Management: - Optimize coding workflows, ensuring efficient charge capture and clean claim submission. - Collaborate with billing, AR, and denial management teams to reduce denials, enhance revenue recovery, and improve coding accuracy. - Track key performance indicators (KPIs) such as clean claim rates, denial rates, coding accuracy, and compliance scores. - Drive coding automation initiatives to improve operational efficiency and minimize manual errors. Cross-Functional Collaboration & Leadership: - Work closely with operations, compliance, and technology teams to refine and enhance coding service offerings. - Lead and mentor onshore and offshore coding teams, ensuring high performance and adherence to compliance standards. - Partner with business development teams to support client onboarding, process improvement initiatives, and contract renewals. - Act as an RCM Subject Matter Expert (SME) in internal strategy discussions and client engagements. Required Qualifications: - Bachelor’s degree in Healthcare Administration, Business, or a related field (Master’s preferred). - 7+ years of experience in medical coding, auditing, and revenue cycle management in a leadership role. - Certification required: CPC, CCS, or equivalent (AHIMA or AAPC certification preferred). - Strong understanding of payer policies, claims processing, medical necessity guidelines, and risk adjustment methodologies. - Experience in coding audits, denial resolution, and revenue integrity initiatives. - Proficiency in RCM platforms, EHR/EMR systems (Epic, Meditech, Paragon, etc.). - Experience managing onshore/offshore coding teams and handling multi-client engagements. - Strong analytical, problem-solving, and negotiation skills with the ability to translate…