Job Description

Team & Operations Management:

Supervise and manage the daily activities of the surgery coding and audit teams, including in-house and contract auditors.

Allocate workload, monitor performance, and ensure timely completion of assigned tasks in alignment with project timelines.

Conduct regular team meetings to communicate updates, review performance, and address challenges or process changes.

Foster a positive and productive work environment that encourages collaboration and accountability.

Quality & Productivity Oversight:

Ensure that coding audits meet defined accuracy, quality, and productivity benchmarks.

Review audit results, identify trends or recurring issues, and implement corrective actions to maintain quality standards.

Collaborate with Quality Assurance and Training teams to address performance gaps through targeted coaching and retraining.

Process Management & Improvement:

Monitor operational workflows to identify bottlenecks and recommend process enhancements for greater efficiency.

Support the development and implementation of best practices in surgical coding operations.

Ensure seamless coordination between coding, auditing, and training functions to maintain alignment with business objectives.

Compliance & Reporting:

Ensure strict adherence to HIPAA, OIG, and other compliance and confidentiality regulations.

Maintain and track key performance metrics, preparing regular reports for senior management.

Address audit discrepancies, process deviations, and non-compliance issues promptly and effectively.

Stakeholder & Client Coordination:

Act as a point of contact between the audit team, management, and clients to ensure smooth communication and issue resolution.

Participate in client calls and internal reviews to discuss project status, performance, and quality outcomes.

Support audit planning and resource allocation based on client requirements and project priorities.

Responsibilities and Essential Functions:

• Understand the payer process of Surgery, APC, Outpatient.
• Application of coding and clinical information.
• Provide inputs and solutions to automatically recognize and extract data from medical documents for proper coding and to facilitate auditing.
• Prompt response to all the emails and requirements.
• Reporting to the manager as appropriate.
• Excellent project management skills, multi-tasking, training skills.
• Strong PC skills; Excel, Word, PowerPoint and internet-based programs
• Excellent verbal and written communication
• Experience in Strategic management
• Perform analysis of benchmarking.
• Research updated coding information
• Research coding issues that arise
• Maintain knowledge of Surgery coding and clinical concepts.
• Flexibility

Requirements :(AM-B1)

• Medical Coding or Auditing experience in Surgery Coding (outpatient, Prof, APC, ASC etc.)
• CPC, COC or other AAPC/AHIMA coding certification
• Auditing experience – desired
• Radiation Oncology coding/auditing experience – desired
• 7+ years relevant coding experience
• Open for an IC role (Independent Contributor)