Machinify
Manager, Medical Review Coding — Behavioral Health
US
Sponsorship not specifiedDetected 16 days ago
ComplianceExcelInventory ManagementPerformance ManagementHIPAAEHR/EMRICD-10ResearchLeadershipCommunicationCollaborationMentoringMicrosoft Office
About the role
- Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country.
- Responsible for driving strategy activities including needs assessments, capacity planning, staffing models, cost/benefit analysis, and establishing productivity and quality standards specific to behavioral health audit operations.
Responsibilities
- Manages daily activities of coding audit staff
- Leads development of training materials and best practices
Requirements
- Performs other duties as required and assigned to meet business needs.
Nice to have
- Current certification as a CPC, CPC-P, RHIA, RHIT, or CCS, required
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Benefits
- We're constantly reimagining what's possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.
- Provides operational oversight of the outpatient behavioral health coding audit team
- serves as the primary subject matter expert for behavioral health coding including psychiatric and psychological services, substance use disorder treatment, ABA, H-codes, and HCPCS Level II behavioral health codes.
- Leads development, maintenance, and refinement of behavioral health review guidelines and audit concepts, ensuring alignment with CMS, Medicaid, and commercial payer policies
- monitors and interprets regulatory and policy changes including DSM-5 updates, coverage expansions, Medicaid carve-out requirements, and parity regulations.
- provides behavioral health-specific guidance, trend identification, coaching, and constructive feedback to drive performance and quality outcomes.
- participates in department and client-facing meetings and presents behavioral health coding findings, solutions, and provider education as needed.
- ensures all audit staff are equipped with current tools, resources, and training to perform behavioral health coding audits accurately and efficiently.
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This listing is sourced directly from Machinify's careers page and normalized into a canonical job model.