Machinify

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.

This listing is sourced directly from Machinify's careers page and normalized into a canonical job model.