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Head of Medical Coding Operations
2 months ago
This role is fully remote and open to candidates nationwide.
A leading medical claims organization is seeking a Head of Medical Coding Operations to oversee the coding department and enhance the efficiency of the review process by pinpointing and executing improvements that drive measurable results.
Key Responsibilities:
- Oversee daily workload and ensure that turnaround time expectations are consistently achieved.
- Contribute to the formulation, execution, and oversight of organizational strategies, initiatives, KPIs, and performance standards; effectively communicate organizational goals and objectives.
- Regularly analyze productivity trends and provide guidance as necessary.
- Mentor and develop team members (both in-house and outsourced) to achieve peak performance and create performance enhancement plans when needed.
- Ensure compliance with all production and quality benchmarks, including caseload, accuracy, review duration, scheduling, and capacity.
- Identify and execute process enhancements, quality improvements, and cost-saving initiatives.
- Formulate and implement policy and procedural recommendations to align with the needs of the organization.
- Supervise and approve staff scheduling, including vacation and sick leave.
- Collaborate with internal stakeholders, including medical professionals, nursing staff, technical teams, and client partners.
- Assist in the creation of innovative clinical and coding review concepts.
- Manage relationships with external vendors.
Required Qualifications:
- Possession of RHIA, RHIT, CCS, or CIC certification (one required).
- A minimum of 10 years of experience in DRG coding, including acute care inpatient coding, auditing, and/or Payment Integrity DRG Validation.
- Proven management and leadership experience.
- Commitment to adhering to Official Coding and Reporting guidelines, AHA Coding Clinic determinations, and compliance with CMS and other regulatory standards.
Compensation: $160,000 - $180,000