Senior Director Coding Services
$147,000–$183,000 year
RemoteUnited States
Job Summary
Direct and implement strategic efforts across Risk Adjustment coding operations to achieve client expectations and project timelines. Ensure production plans for training, quality, and audit meet deadlines while identifying performance gaps and developing reduction strategies. Coordinate with executive departments on client contracting and service level agreements, analyzing quality reports and SLAs to drive continuous process improvement. Oversee onshore and offshore coding production and accuracy, managing staff hiring, mentoring, and vendor performance across multiple client teams. Use data to monitor productivity, address team concerns, and communicate internal system reports for production and quality accuracy. Participate in production and quality meetings to execute coding plans, conduct targeted audits, and implement activities to affect change through mentoring and focused training. Resolve issues impacting coding production for MRA, CRA, and Medicaid by collaborating with IT, Data Operations, and Human Resources. Attends client meetings with Client Services staff and professionally communicates non-compliance findings to leadership and managers. Hire, develop, and retain top-tier talent to build a culture supporting high internal and external customer satisfaction.
Required Qualifications
- Coding certification: RHIA, RHIT, CCS, CCS-P, CPC, CPC-H (nationally certified medical coder as certified by either AAPC or AHIMA)
- CRC a plus
- BS Degree preferred. May be substituted for 10+ years of medical coding/record abstraction experience
- 10+ years of HCC or Risk Adjustment experience
- 5+ years' experience managing both coding production and quality/audit staff
- 3+ years in a leadership role with formal direct reports
- 5+ years working in a client-facing role, deep understanding of business needs of our clients, including challenges they face and other industry trends occurring. Ability to translate these needs into concrete initiatives with strong business cases supporting decisions, including understanding of key specific user personas and their definitions of value
- Ability to establish, monitor, and enforce staffing and production schedules for both coding and quality staff
- Ability to use data to identify production and quality trends and collaborate with the managers and team leads to develop plans to affect change where needed
- Act as a coding subject matter expert for client coding guideline development ensuring compliance and accuracy to utilize appropriate resources for Medicare, Medicaid, and Commercial Risk Adjustment as required
- Excellent written and communication skills including coaching and interpersonal skills and client interaction
- Analytical and critical thinking skills to understand data to influence decision-making
- Highly proficient in computer applications and technology, with advanced Excel skills
- Manage multiple client deliverables and competing deadlines simultaneously
- Awareness and adherence to HIPAA privacy and security regulations
- Minimal travel requirements
- After hours and/or weekend work may be required when necessary for major deliverables/deadlines
- Must have flexibility and willingness to participate in the work processes of an international organization, including conference calls scheduled to accommodate global time zones
- Must be able to perform duties with or without reasonable accommodation
- Must be able to provide a dedicated, secure work area
- Must be able to provide high-speed internet access/connectivity and office setup and maintenance
Desired Qualifications
- BS Degree preferred. May be substituted for 10+ years of medical coding/record abstraction experience
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